‘I have a sinus infection.” It’s one of the most common statements that I hear. The problem leads to 25 million office visits in the United States every year.
In this country, more than 90 percent of adult patients with a diagnosis of sinusitis receive an antibiotic. But recent studies suggest this practice may be doing more harm than good.
SINUS INFECTION STUDIES
Researchers from the University of Southampton in England conducted a randomized, controlled study of 240 adults with acute sinusitis over a period of four years. Each participant, diagnosed with sinusitis based on symptoms, then received one of four treatments: an antibiotic, a cortisone nose spray, both or neither.
The researchers found that neither the antibiotic nor the cortisone nose spray, alone or in combination, was effective in reducing the symptoms or duration.
The study reinforces the lack of benefit from antibiotics shown in a number of other studies, said Dr. Morten Lindbaek in an accompanying editorial in the Journal of the American Medical Association.
“Most patients with acute sinusitis recover without antibiotic treatment,” Lindbaek said.
Another study from the University of Nebraska found that, though antibiotics are usually prescribed for sinusitis, the medications only kill bacteria, and not viruses at the heart of most sinus infections.
SOME HARMFUL EFFECTS
Despite these findings, wide-scale antibiotic treatment of sinusitis continues. This expensive practice unnecessarily exposes people to potential side effects such as allergies, rashes and diarrhea.
Widespread use of antibiotics also encourages the development of resistant bacteria. Many of the bacteria that can cause respiratory infections — such as pneumococcus, streptococcus, haemophilus and moraxella — have become resistant to commonly available antibiotics.
One study found a 10-fold increase in resistant bacteria that was linked with frequent use of antibiotics.
WHAT’S THE ALTERNATIVE?
While patients often attribute getting well to taking antibiotics, research indicates that up to 85 percent of those with acute sinusitis would improve on their own without medication. The American Academy of Otolaryngology, an organization of ear, nose and throat specialists, has made the following recommendations:
In patients with mild, uncomplicated acute sinusitis and a temperature of less than 101 degrees, the condition can be managed with symptom relief and observation instead of antibiotics..
If the patient’s condition fails to improve after seven days, or worsens at any time, antibiotics are recommended.
In addition, “Some patients with sinusitis are more ill than others with fever, malaise and deteriorated general condition,” Lindbaek said. “These patients still are in need of antibiotics.”
BENEFICIAL SELF-CARE
But most people have milder forms of sinusitis. Research has shown that home treatment can provide relief for these patients.
Symptoms such as sinus congestion, cloudy nasal drainage, and facial pain or pressure may respond to simple measures such as these:
Drink ample fluids; get plenty of rest.
Use a vaporizer or take a steamy shower.
Learn how to do nasal saline irrigation.
If you use an over-the-counter decongestant nose spray, limit use to three days.
Contact your doctor about symptoms that persist more than a few days. In some cases, a prescription to ease the pressure and congestion in the sinuses may help.
And see your doctor right away if your condition worsens or you develop a high fever, stiff neck, severe headache, confusion or swelling near the eyes.
For more information: American Academy of Family Physicians, familydoctor.org.
Contact Dr. Elizabeth Smoots at doctor@practicalprevention.com.
&Copy; 2008 Elizabeth S. Smoots
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
