Antibiotics no help against most sinus infections,finds study

Research by doctors at the Washington University School of Medicine has shown that antibiotics have little effect on rhinosinusitis commonly known as sinus infection

Research by doctors at the Washington University School of Medicine has shown that antibiotics have little effect on rhinosinusitis commonly known as sinus infection. The research,published in the Journal of American Medical Association (JAMA) was designed to look at antibiotic efficacy in the common infection in the backdrop of rising antibiotic resistance.

A total of 166 patients with rhinosinusitis symptoms like runny nose,congestion,toothache,reduced sense of smell etc were a part of the study. The study group was administered a 10-day course of the antibiotic amoxicillin while the other group was given an inactive placebo pill. Of the total subjects,92 per cent simultaneously received medication for symptomatic relief.

Among patients with acute rhinosinusitis,a 10-day course of amoxicillin compared with the placebo pill did not reduce symptoms on day 3 of the treatment, the study concluded.

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There were no statistically significant differences in reported symptom improvement on day 3 (37 per cent for amoxicillin group vs 34 per cent for control group) or on day 10 (78 per cent for amoxicillin group vs 80 per cent for control group). On day 7,more participants treated with amoxicillin reported symptom improvement (74 per cent for amoxicillin group vs 56 per cent for control group), says the study.

With more and more cases of viral upper respiratory tract infections being reported,doctors here say that the study is an eye-opener. There has been so much discussion on antibiotic misuse and overprescription yet somehow the practice continues. It is a fairly big study and goes a long way in reiterating the fact that antibiotics should be used judiciously. Acute sinusitis may be viral or an allergic reaction and the study shows that for the doctor the more important decision may not merely be which medicine to prescribe but also when not to prescribe antibiotics, said Dr Rajeev Puri,senior consultant ENT surgeon,Indraprastha Apollo Hospitals.

Others are less convinced,particularly because the researchers have not specified the kind of infection in the subjects.

I would have been more convinced if they had done a test to find out whether the infection was viral or bacterial before enrolling the subjects. Obviously,antibiotics will not work for viral sinusitis. All this study effectively proves is that most acute sinusitis cases are viral and this we already know. I am sure if they had categorised the infections,the drug would have been found to be effective for bacterial infections, says Dr Vikas Malhotra,associate professor in the department of ENT,Maulana Azad Medical College.