Add sinus infections to the list of ailments antibiotics can't clear out of your system. While one in five antibiotics prescriptions in the United States are filled for sinus infections, also known as sinusitis, a new study by Washington University School of Medicine in St. Louis found they are no better than an inactive placebo pill in eliminating the related nasal symptoms.
"Patients don't get better faster or have fewer symptoms when they get antibiotics," wrote Jay F. Piccirillo, MD, professor of otolaryngology and the study's senior author in a released statement. "Our results show that antibiotics aren't necessary for a basic sinus infection - most people get better on their own."
What they did
One hundred and sixty-six adults with acute sinus infection with symptoms classified as moderate, severe or very severe, were randomly assigned a 10-day course of either the antibiotic amoxicillin or a placebo pill. In an acute sinus infection symptoms may last up to four weeks. All study participants also received medicine for relieving pain, fever, cough and congestion.
Using a patient-answered quality-of-life questionnaire, researchers assessed the patients' symptoms at the start of the treatment, and on three, seven, 10 and 28 days afterward. Researchers also compared symptom relapse and recurrence as well as the number of days patients missed from work as a result of the infection.
At day three, researchers found no difference between the antibiotic and placebo groups in any of these measures. At day seven, researchers noted a small improvement in the antibiotic group's questionnaire scores, but argued this change in scores was unlikely to represent a noticeable relief from symptoms. By day 10, 78 percent of those on antibiotics and 80 percent of patients given the placebo reported their symptoms were very much improved or cured.
Why antibiotics don't work
As with anything medical, antibiotics are used to treat bacterial infections. But only two percent of sinus infections are bacterial, according to the American Council on Science and Health.
The researchers caution about the overuse of antibiotics for sinus infections in their study published in the Feb. 15 edition of the Journal of the American Medical Association. "We feel antibiotics are overused in the primary-care setting," said the study's lead author Jane M. Garbutt, MD, in a released statement. "We hope this study provides scientific evidence that doctors can use with patients to explain that an antibiotic is not likely to help an acute sinus infection."
What does work
The Washington University researchers suggest treating symptoms, such as pain, cough and congestion, with watchful waiting to see whether further treatment is necessary.
In addition, it might help to know what is causing your acute sinusitis in order to help treat it. Asthma and allergies can trigger a sinus infection, and the National Institutes of Health offers related prevention and treatment measures to consider if that's the case.
The Institute for Quality and Efficiency in Healthcare also offers a broad overview of the latest international medical literature available on sinus infections, including recommended treatment options available and their efficacy.