No antibiotics for sinusitis? -JAMA

A new study published in the Journal of the American Medical Association disputes benefit provided by antibiotics for sinus infections.  In this study patients were randomly given a placebo pill or amoxicillin (a basic first-line antibiotic for sinus infections) for 10 days.  They found that there was no difference in symptom improvement at day 3 or day 10 of antibiotic treatment.

What does this mean?  The study’s main effect will be to give primary care doctors more evidence to refrain from giving antibiotics for early-stage infections.  This is something doctors already know, however there is heavy pressure from many patients that essentially demand and expect a dose of antibiotics for viral illnesses.  This results in many many healthcare dollars going towards medicines that do no good.

This study does not address patients with prolonged sinus symptoms, or the double-flare whereby an obvious “cold” seems to get better then reverses course and “settles into” the sinuses and worsening again a week or so later.

Amoxicillin for Acute Rhinosinusitis, February 15, 2012, Garbutt et al. 307 7: 685 — JAMA.

(This begs the question, “when do I go to the doctor with a respiratory infection”?  This will be the topic of an upcoming feature post.)