Some antibiotics may be ineffective against acute sinusitis, study indicates.
The AP (12/5, Tanner) reports that according to a study published in today's issue of the Journal of the American Medical Association, "people suffering from facial pain and a runny nose with greenish or yellowish mucus generally improved within about two weeks -- whether they took the standard antibiotic amoxicillin, steroid nose spray [budesonide], or fake medicine." This finding may have important implications for antibiotics, "particularly the penicillin-like drug amoxicillin," which "are among the most commonly prescribed medicines for sinus infections." Dr. Vincenza Snow, a Philadelphia internist and director of clinical programs and quality of care at the American College of Physicians, points out that "while antibiotics are designed to treat bacteria, these drugs aren't always very effective at treating bacterial sinus infections because the medicine has a tough time reaching the sinuses."
According to the Los Angeles Times (12/5, Chong), lead author Ian G. Williamson, M.D., a family medicine researcher at the University of Southampton in England, and colleagues, found that rather than helping patients with sinus infections, antibiotics may actually "harm them by increasing their resistance to the drugs." The researchers concluded that "patients should be more willing to forgo antibiotics, although they should still check with their doctors when a cold worsens into a sinus infection." Typically, "the body will usually heal itself" if people are patient, said Dr. Williamson. This statement is based on the fact that the same percentage of patients "got well in 10 days," regardless of "whether they took an antibiotic or a placebo."
MedPage Today (12/5, Gever) reports that about "92 percent of patients with acute sinusitis in Britain, and 85 percent to 98 percent of such patients in the U.S., receive antibiotics, even though doctors rarely confirm a bacterial infection." The researchers conducted a "double-blind study" of "240 patients seen in family practice clinics over a four-year period for uncomplicated acute sinusitis." Participants "were assigned to four treatment groups: 500 mg of oral amoxicillin three times a day for seven days plus a nasal placebo; 200 micrograms of budesonide nasal spray once daily for 10 days plus an oral placebo; both active drugs; and both placebos." According to the researchers, this "was the largest randomized, placebo-controlled study of amoxicillin in acute sinus infection ever conducted without pharmaceutical company funding, and the only 'adequately powered' study of budesonide in these patients."
HealthDay (12/5, Gardner) adds that for the "amoxicillin group, 29 percent of patients had symptoms lasting at least 10 days, and 33.6 percent of those not receiving amoxicillin had the same symptom length of time." For "both the budesonide and no-budesonide groups, exactly 31.4 percent of patients had symptoms lasting at least 10 days." The researchers said that the "nasal steroids seemed to be more effective in individuals who had less severe symptoms."
According to WebMD (12/5, DeNoon), the research team concluded that based on their findings, they "are confident that if there is an effect of antibiotics on acute sinus infections, it is not very big -- certainly not as big as people have been led to believe."
Pennsylvania's CBS affiliate KDKA-TV (12/5) reports that about "40 million Americans will get a sinus infection this year, and they will spend $6 billion on it." But, these findings suggest that "spending all that money may not be worth it."
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