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Forget about antibiotics for sinusitis, they are overprescribed and ineffective [Image: mcfarlandmo - Wikimedia Commons]

Antibiotics no better than placebo for sinusitis

16 February, 2012

Natural Health News — Antibiotics that doctors typically prescribe for sinus infections do not reduce symptoms any better than a placebo.

That’s according to a small US study published in the Journal of the American Medical Association (JAMA). The study included 166 adults whose symptoms fit the criteria for acute sinus infection as defined by experts at the Centers for Disease Control and Prevention.

To participate, patients’ symptoms had to be classified as moderate, severe or very severe. Specifically, they had to report pain or tenderness in the face and sinuses and nasal discharge that lasted between seven and 28 days. Patients with chronic sinus infections or serious complications from the condition, such as a simultaneous ear or chest infection, were not included in the study.

The patients were recruited at their primary-care physicians’ offices and randomly assigned to receive a 10-day course of either amoxicillin or placebo. Whether on amoxicillin or not, all patients also got medications for relieving pain, fever, congestion and cough.

The researchers assessed monitored the patient’s progress three, seven, 10 and 28 days after starting treatment as well as comparing relapse and recurrence of symptoms and days missed from work.

At day three, they found no difference between the antibiotic and placebo groups in any of these measures. At day seven, a small, but statistically insignificant improvement was seen in the antibiotic group. By day ten, when about 80% of patients in both groups reported their symptoms were very much improved or cured.

They also found no difference between the antibiotic and placebo groups in the amount of medications patients chose to use to alleviate pain, fever, congestion and cough.

In the UK Around 90% of people with sinusitis in the UK are prescribed antibiotics. In the United States as many as one in five antibiotic prescriptions are for sinus infections. Given the rise of bacteria resistant to such drugs the researchers said, it is important to understand whether the drugs were working or not. Clearly they are not.

In the UK a 2008 study found that 15 patients with sinusitis would a have to be given antibiotics to produce one cure.

“It’s a nasty disease,” said Dr Jane Garbutt, who led the research team.  “People have significant symptoms. They feel miserable and miss time from work. If an antibiotic is not going to be of any benefit, then what is? That’s a question we haven’t answered yet. But we are working on it.”

Sinusitis is very common – often occurring after colds or flu – with 1-5% of adults diagnosed every year and there are, in fact, many ways of speeding your recovery from what can be a painful problem.

For natural ways to treat sinus problems see this article by NYR therapist Rima Shah. You might also want to read NYR Natural News Editor Pat Thomas’ comprehensive rundown of antibiotic alternatives.