chambers92

updated 2:05 p.m. MT, Tues., Dec. 4, 2007

CHICAGO - Just in time for runny nose season, new research suggests routine sinus infections aren’t really helped by antibiotics and other medicine that’s often prescribed.

In the British study, people suffering from facial pain and a runny nose with greenish or yellowish mucous generally improved within about two weeks — 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 previous findings in children.

Antibiotics, particularly the penicillin-like drug amoxicillin, are among the most commonly prescribed medicines for sinus infections.

Steroid sprays sometimes are used, but the study found they also were no better than dummy drugs, although they appeared to provide some relief for patients with only minor symptoms.

The study should lead to a “reconsideration of antibiotic use for acute sinusitis. The current view that antibiotics are effective can now be challenged, particularly for the routine cases which physicians treat,” said lead author Dr. Ian Williamson of the University of Southampton in England.

“Physicians can focus on effective remedies that improve symptom control,” which include ibuprofen and other over-the-counter painkillers, Williamson said.

Inhaling steam and squirting salt water into the nose to flush out thick mucous are among other methods that sometimes provide relief, he said.

The study appears in Wednesday’s Journal of the American Medical Association.

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.

Patients on the drugs didn’t get better quicker than those using the placebo.

31 million sinus infections diagnosed in U.S.
Sinus infections are diagnosed in about 31 million Americans each year and are among the most common reasons for doctor visits. In the United Kingdom, primary care doctors see 50 or more cases a year, the study authors said.

The infections affect air spaces called sinuses around the nose and in the lower forehead. Inflammation and excess mucous can cause nose congestion, headaches and eye and face pain. Causes include bacteria, viruses, fungal infections and allergies.

Despite a long-held notion, recent studies have found that yellowish or greenish mucous doesn’t always mean the infections are bacterial, said Dr. Vincenza Snow, a Philadelphia internist and director of clinical programs and quality of care at the American College of Physicians.

Moreover, while antibiotics are designed to treat bacteria, these drugs aren’t always very effective at treating bacterial sinus infections because the medicine has a tough time reaching the sinuses, she said.

The U.S. physicians’ group issued guidelines in 2001 advising against using antibiotics for most sinus infections in otherwise healthy people, blaming overuse for contributing to the growing problem of bacteria resistant to drugs.


The group is considering updating the guidelines to say recent evidence reaffirms the drugs “don’t really change the course of the illness,” Snow said.

Dr. Marvin Fried, otolaryngology chairman at Montefiore Medical Center in New York, questioned whether all the patients in the study had true sinus infections. While patients were recruited by family doctors, the results were based on patients’ self-reported symptoms rather than medical exams, he noted.

Still, Fried said the conclusions are in line with September guidelines from a group of head and neck doctors, whose treatment options included observation without antibiotics for mild sinus infections.

© 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

http://www.msnbc.msn.com/id/22101005/

Teri B.

Yeah, I could tell you some horror stories about this. My stomach lining is about gone from all the antibiotics I've taken for sinus infections, but it wasn't till I had sinus surgery that it finally got under control. Overuse of antibiotics will be the death of us all! I've taken some of them to the point that I've developed a severe allergic reactions to them. IDIOT DOCTORS!

chambers92

I used to take a lot of antibiotics also. Until I found a good ENT who knew that most "sinus infections" were either viral or an allergic inflamation.

Teri B.

What do you do now?

I've gone to 3 different ones over the last 7 or 8 years. The 2nd did the surgery, but the latest one is more for steriod shots. If I'd use the sinus steriod sprays, it would probably help, but I just hate them so much I can't make myself use them for any substantial period of time.

ciaobox2007

Hey Teri...I've had a cough and sinus infection for almost a year now. Three different rounds of antibiotics from various doctors, none have worked. I'm inclined to believe you girl!

I've just chalked it up to being allergic to something/one in my household at this point.

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chambers92

I don't like the steroid sprays, they never seemed to work. And sinus surgery didn't do much either.

The only thing that seems to help a little is a sinus rinse call Neilmed..You can buy the packets and kit at most pharmacies. Or online at www.neilmed.com

Or go near an ocean for a while. Nothing like ocean air for sinus problems.

Teri B.

Sounds like you've got one of those infections that's dug in deep. I had one under my right eye for over a year. And another over my left jaw for ages. When they did the surgery, they had to clean out that one over my jaw (gross sorry). Those are a bitch cause they lay over the nerves of your teeth and hurt like a SOB. They also broke up some areas of bone (not really bone but I don't know how else to describel it) in two areas to open up the sinuses and then fixed a deviated septum. Surgery helped me more than anything, but when it's alergies, you're just screwed.

We have Ozone alerts here, and my sinuses go apeshit during those times, and we have this horrifying gunk that just hangs in the air over the city. I never had sinus problems till I moved here. I need to move to the desert for health reasons, and for sunbathing reasons.

aloysious

I've had patients pissed and leave my practice because I wouldn't prescribe them antibiotics for stuff that antibiotics are known not to have any effect on and is in peer reviewed literature that states so . I say GOOD RIDDANCE, IDIOT PATIENTS!
Some asses actually demanded their complimentary Rx for antibiotics when they leave my office "just in case"...IDIOT PATIENTS!
You'd be amazed at the number of patients I've tried to explain that antibiotics are not indicated for their particular ailments, yet they demand them anyway.

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chambers92

Dry desert air isn't good for sinus problems either.

Although is seems like so many people have sinus problems these days no matter what kind of climate they live in.

Teri B.

GOOD FOR YOU! This is one of those things that really makes me mad. How the heck am I, the patient, supposed to know that these antibiotics are doing nothing but hurting me?!? Now I'm SEVERELY allergic to Levequin, Cypro, and all those antibiotics in that family and God only knows what other ones. About a year ago, I almost died of anaphylactic shock. By the time the ambulance got to my house, my entire body was blood red, I was itching all over so bad I wanted to die, my BP was 80/40, my heart rate was faultering, and my throat was closing. This was after taking Levaquin for 3 days, for about the 10th time. WTF?!? Now, I rarely take antibiotics. But what the HELL will I do if I really need them?