May 24, 2018
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Antibiotics no better for sinus infections than waiting it out, study finds

Metro Creative | BDN
Metro Creative | BDN
By Jennifer LaRue Huget, Special to The Washington Post

When you have a sinus infection, the first thing you want is relief from your pain. If you’re like most people, you want your doctor to prescribe an antibiotic to speed that process. And the last thing you want is to be told to just wait it out.

But a study released Tuesday afternoon adds to the growing body of science suggesting that with some infections, including those of the sinuses, antibiotics aren’t the best course of treatment and that waiting it out may indeed be the best approach after all.

Over-use of antibiotics is considered an important and growing public-health problem, as disease-causing bacteria continue to develop resistance to the drugs we rely on to kill them. According to the new study, 1 in 5 prescriptions for antibiotics in the U.S. is for a sinus infection.

Researchers at Washington University School of Medicine in St. Louis, Missouri report in the Feb. 15 issue of the Journal of the American Medical Association that in their study of 166 adults with sinus infections, those who were given the antibiotic amoxicillin didn’t feel better any faster than those who received a placebo. People in both groups experienced about the same amount of relief after three days.

“There is now a considerable body of evidence . . . that antibiotics provide little if any benefit for patients with clinically diagnosed acute rhinosinusitis,” the researchers wrote. “Yet, antibiotic treatment for upper respiratory tract infections is often both expected by patients and prescribed by physicians.”

Jay Piccirillo, one of the study’s authors, said researchers chose the three-day mark because, while it’s well established in the scientific literature that most sinus infections resolve by 10 days with or without antibiotics, they wanted to see whether antibiotics hastened resolution. If their work had shown that antibiotics made people feel much better by day 3, he says, using the drugs might have been shown to be worthwhile.

By day 7, the group receiving antibiotics was scoring better than the placebo group on some reported symptoms like headache, facial pain and nasal discharge, but Piccirillo said the differences between the two groups were not big enough to translate into a noticeable difference for most patients.

Patients in both groups were permitted to use a handful of over-the-counter medications to manage their pain, fever, cough and nasal congestion.

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