The latest on Antibiotics and Sinus Infections

2012 February 16
by Daniel Lakeland

If you have small children, you will eventually get an upper respiratory infection. Sinus infections are one common type, and they often come from an opportunistic bacterial infection following a viral infection.

A recent article in JAMA¬†says that Amoxicillin has only a mild effect, essentially speeding recovery by a few days. They mention that these are “uncomplicated” cases. In my experience these infections are relatively frequently accompanied by complication, namely bacterial bronchitis.

It’s interesting how the ¬†authors put a spin on this result. Essentially their study seems to show that from day 6 to day 10 the Amoxicillin takers are more comfortable but by day 10 the two groups are the same. They then conclude that these 3 to 4 days of comfort are basically worthless and that in general antibiotics should not be prescribed for sinus infection. This is not the only conclusion possible for the study.

2 Responses leave one →
  1. KevinH permalink
    February 16, 2012

    I can’t access the full text, but was the context of the authors’ conclusion something like “given the long-term costs of excessive antibiotic treatment, 3-4 days of comfort are basically worthless, and in general antibiotics should not be prescribed for sinus infection if other bacterial infections are not present”?

    That would make a lot more sense.

  2. Daniel Lakeland
    February 17, 2012

    The actual article is a little more reasonable than the media reporting on this article. From the conclusion of the article:

    “In conclusion, evidence from this study suggests that treatment with amoxicillin for 10 days offers little clinical benefit for most patients with clinically diagnosed uncomplicated acute rhinosinusitis. It is important to note that patients with symptoms indicative of serious complications were excluded from this trial and likely need a different management strategy”

    I imagine that patients with bronchitis related to a primary sinus infection were excluded from the study group for example.

    This is a much more careful statement than the one you will typically find in general media reporting of the results. Mass media science writing strikes again.

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