No more antibiotics for sinusitis.
Article Type: Brief article
Subject: Antibiotics (Dosage and administration)
Sinusitis (Diagnosis)
Sinusitis (Drug therapy)
Author: Cowper, Anne
Pub Date: 09/22/2008
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2008 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Fall, 2008 Source Volume: 20 Source Issue: 3
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 186902610
Full Text: Schumann S-A, Hickner J. 2008. Patients insist on antibiotics for sinusitis? Here is a good reason to say "no". J Fam Prac 57:7;464-8.

Antibiotics have little if any positive effects on the severity and duration of symptoms of acute sinusitis, and they cause adverse effects and create unnecessary expense.

Review of data from the National Ambulatory Medical Care Surveys (NAMCS) from 1999 to 2005 shows that around 80% of cases of acute sinusitis were treated with antibiotics. A meta analysis of 13 randomised controlled trials found that sinusitis improved without antibiotics. The meta analysis found that 15 patients were required to be treated with antibiotics to benefit 1 patient two weeks after treatment commenced. The studies found that the duration of illness does not predict a positive response to antibiotics.

Side effects of antibiotics (such as diarrhea) are 80% more common among patients with sinusitis compared with placebo. Treatments should include pain medication for the facial pain or headache, and saline nasal spray for the nasal discharge. Antibiotics or nasal corticosteroids are not recommended. Side effects will be fewer and costs will be lower.
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