Public release date: 4-Dec-2007

A comparison of common treatments for acute sinusitis that included an antibiotic and a topical steroid found neither more effective than placebo, according to a study in the December 5 issue of JAMA

Acute sinusitis (sinus infection) is a common clinical problem with symptoms similar to other illnesses, and is often diagnosed and treated without clinical confirmation. Despite the clinical uncertainty as to a bacterial cause, antibiotic prescribing rates remain as high as 92 percent in the United Kingdom and 85 percent to 98 percent in the United States, according to background information in the article. “Because there are no satisfactory studies of microbiological etiology from typical primary care patient practices, wide-scale overtreatment is likely occurring,” the authors write. Concerns about wide-spread antibacterial use include increasing antibiotic resistance in the community. Anti-inflammatory drugs such as topical steroids are also used as a treatment and may be beneficial, but there has been limited research

“Our main conclusions are that among patients with the typical features of acute bacterial sinusitis, neither an antibiotic nor a topical steroid alone or in combination are effective in altering the symptom severity, the duration, or the natural history of the condition. Topical steroids are likely to be effective in those with such features but who have less severe symptoms at presentation to the physician,” the authors write