Study finds medicines offer little sinus benefit
Antibiotics and other drugs used against routine infections did little, researchers said.
CHICAGO - The antibiotics and other medicines often prescribed for routine sinus infections - among the most common reason for doctor visits - do virtually nothing, researchers report today.
People suffering from facial pain and a runny nose with greenish or yellowish mucous generally improved within about two weeks in the British study - regardless of whether they took the standard antibiotic amoxicillin, steroid nose spray or fake medicine.
The results, based on patients' reporting whether their symptoms had improved, echo earlier findings in children.
Antibiotics, particularly the penicillinlike drug amoxicillin, are among the most commonly prescribed medicines for sinus infections.
Steroid sprays sometimes are used, and they also were no better than dummy drugs in the study, although they seemed to provide some relief for patients with minor symptoms.
The findings should lead to a "reconsideration of antibiotic use for acute sinusitis," said lead author Ian Williamson of the University of Southampton in England.
"Physicians can focus on effective remedies that improve symptom control," he said - ibuprofen and other over-the-counter painkillers.
Inhaling steam and squirting salt water into the nose to flush out thick mucous are among other methods that may provide relief, he said.
The study appears in today's Journal of the American Medical Association.
The researchers randomly assigned 240 adults to receive one of four treatments: 500 milligrams of amoxicillin three times daily for seven days and 400 units of steroid spray for 10 days; only amoxicillin; only steroid spray; or fake medicine.
The results were all roughly the same.
Sinus infections are diagnosed in 31 million Americans a year.
They affect the air spaces around the nose and in the lower forehead. Inflammation and excess mucous can cause nose congestion, headaches, and eye and face pain. Among the causes are bacteria, viruses, fungal infections and allergies.
Recent studies have debunked a long-held notion that yellowish or greenish mucous always means the infections are bacterial, said Philadelphia internist Vincenza Snow.
And while antibiotics are designed to combat bacteria, they aren't always effective with bacterial sinus infections because the drugs have difficulty reaching the sinuses, said Snow, who is director of clinical programs and quality of care at the American College of Physicians.
The physicians' group issued guidelines in 2001 advising against antibiotics for most sinus infections in otherwise healthy people, blaming overuse for contributing to the growing problem of antibiotic-resistant bacteria.
The group is considering updating guidelines to say recent evidence reaffirms the drugs "don't really change the course of the illness," Snow said.