Amoxicillin, the most commonly prescribed antibiotic for sinus infection, works no better than a dummy pill in getting rid of the ailment, a study found.
Three days after starting antibiotics, there were little difference in symptoms between those taking amoxicillin and those given a placebo, according to research today in the Journal of the American Medical Association.
One in five antibiotic prescriptions in the U.S. are given to adults for sinus infections, the authors wrote. The findings suggest doctors avoid routine antibiotic treatment for patients with an uncomplicated sinus infection, they said in the study.
“There’s no clinical benefit for antibiotic treatment for most patients with sinusitis,” Jane Garbutt, the lead study author and research associate professor of medicine at Washington University School of Medicine in St. Louis, said yesterday in a telephone interview. “It’s hard for doctors to not give an antibiotic when there isn’t a good alternative.”
Garbutt suggests doctors hold off on antibiotics for a few days to see if the sinus infection clears up on its own. Over- the-counter painkillers and cold and cough medicines may help treat symptoms until the infection begins to go away, she said. Studies are needed to look at whether treatments like nasal irrigation may ease symptoms, she said.
The study included 166 adults who had moderate to very severe sinus infection symptoms, including pain or tenderness in the face and sinuses and nasal discharge lasting from seven to 28 days. Half were assigned to receive amoxicillin while the others were given a placebo.
After three days, there was little difference between the groups in terms of their quality of life symptoms, including the need to blow their nose, sneezing, headache and fatigue. While some improvement in the antibiotic group was seen after seven days, the difference was unlikely noticed by patients, Garbutt said. By day 10, a similar number of patients in each group said their symptoms were improved or they were cured, the authors said.
“Patients don’t get better faster or have fewer symptoms when they get antibiotics,” said Jay Piccirillo, the study’s senior author and a professor of otolaryngology at Washington University, in a statement. “Our results show that antibiotics aren’t necessary for a basic sinus infection -- most people get better on their own.”
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