For Sinus Infection, Don’t Bother with Antibiotics

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Sinus infections are drippy and painful — an all-around headache, quite literally. When symptoms arise, patients often rush to the doctor for a prescription, usually an antibiotic, to put an end to the suffering.

But it turns out you’d do just as well to take a sugar pill and treat yourself with standard drugstore remedies. According to a new study published in the Journal of the American Medical Association by researchers at Washington University’s School of Medicine in St. Louis, the antibiotics typically prescribed by doctors work no better than placebo for reducing symptoms of infection.

“Patients don’t get better faster or have fewer symptoms when they get antibiotics,” Jay F. Piccirillo, professor of otolaryngology and the study’s senior author, said in a statement. “Our results show that antibiotics aren’t necessary for a basic sinus infection — most people get better on their own.”

The researchers studied 166 adults with acute sinus infection symptoms. Patients were randomly assigned to receive a 10-day course of either amoxicillin or placebo, and nearly all patients also got acetaminophen for pain- and fever-relief, a decongestant, an over-the-counter cough medicine and a saline nasal spray. Most participants used at least some of these.

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Doctors assessed the patients’ symptoms on Day 3, 7 and 10 of the study, and again 28 days later. The researchers didn’t expect to see a difference between the two groups at the later assessments — since sinus infections tend to resolve themselves on their own over time — but they were surprised to find no difference at Day 3. It turned out that patients using antibiotics did not report milder or fewer symptoms than patients on placebo. (Incidentally, doctors gauged patients’ symptoms through a self-reported questionnaire called the Sinonasal Outcome Test-16, or SNOT-16 for short.)

The takeaway for patients is that they should skip the antibiotics for the treatment of sinus infections. Currently, 1 in 5 antibiotic prescriptions in the U.S. are written for sinus infections — not only are the drugs failing to help patients, but their overprescription is also contributing to antibiotic resistance.

“Patients can avoid the complications of antibiotics, and, as a society, we can delay the emergence of new resistant bacteria through the restrained use of antibiotics,” Piccirillo told NPR. “What we want to break is that knee-jerk request for antibiotics, and the doctor’s reaction to give it.”

We’re all for reducing the unnecessary use of antibiotics, but in the meantime, what are we supposed to do to alleviate the troublesome symptoms of a sinus infection? Researchers recommend simply treating congestion and pain with standard over-the-counter medications. That’s about all that can be done for now.

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