Update on Treating Acute Bacterial Sinusitis

Update on Treating Acute Bacterial Sinusitis

Inexpensive antibiotics, such as amoxicillin and folate inhibitors, are just as effective as newer and more expensive antibiotics, such as third-generation cephalosporins, in the treatment of uncomplicated acute bacterial sinusitis, according to a study sponsored by the Agency for Health Care Policy and Research (AHCPR) under its evidence-based practice program. However, the report indicates that in many patients with acute sinusitis, symptoms will resolve without antibiotic treatment.

The research, conducted at the New England Medical Center, is the ninth in a series of evidence reports and technology assessments to provide comprehensive, science-based information on common, costly conditions and health care technologies. The report’s conclusions are based on a systematic review of the best available evidence from published research.

The AHCPR report focuses on the diagnosis and treatment of uncomplicated, community-acquired, acute bacterial sinusitis in children and adults. The investigators of the study report the following findings:

*More patients recovered, and more recovered earlier, when treated with antibiotics as compared with placebo; however, two thirds of the patients receiving placebo recovered without the use of antibiotics.

*More research is needed to identify simple, inexpensive, diagnostic methods to help distinguish patients requiring treatment with antibiotics from those not requiring antibiotics or further evaluation.

*Children need to be the specific focus of clinical research to determine proper methods of diagnosing and treating sinusitis.

*Future studies should examine the connection between treatment and relapse rates or the development of recurrent sinusitis. Studies also should address the optimal length of antibiotic treatment, the role of patient preferences in clinical decision-making and the issue of emerging antibiotic resistance.

A four-page summary of “Diagnosis and Treatment of Acute Bacterial Rhinosinusitis” (AHCPR99-EO15) is available from the AHCPR’s Web site (http//:www.ahcpr.gov/clinic/sinus sum.htm). Complete copies are available from the AHCPR Publications Clearinghouse by writing to P.O. Box 8547, Silver Spring, MD 20907, or by calling 800-358-9295.

COPYRIGHT 1999 American Academy of Family Physicians

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