Most children with acute sinusitis recover without antibiotics

April 01, 2001

St. Louis, April 2, 2001 -- Antibiotics do not help most children with acute sinusitis, according to a study to be published in the April issue of Pediatrics. This finding raises questions about the common practice of prescribing antibiotics to children with long-lasting sinus symptoms.

"Most children with prolonged cold-like symptoms suggestive of acute sinus disease get better within three weeks--without antibiotic therapy," says Jane Garbutt, M.B., Ch.B., instructor of medicine at Washington University School of Medicine in St. Louis. "Our study suggests that, for children with uncomplicated acute sinusitis, it makes sense to delay antibiotic treatment and watch carefully." Garbutt emphasized that it still is important for children to visit their pediatrician to rule out more serious illness, even if antibiotics are not prescribed.

"Antibiotics are expensive and can cause side effects, most commonly diarrhea," Garbutt says. "Another concern is that they are an important factor in the emergence and spread of antibiotic-resistant bacteria."

The researchers studied 180 pediatric patients aged 1 to 18 whose sinus symptoms had persisted for 10 to 28 days. Once the patients were clinically diagnosed with acute sinusitis, they were assigned randomly to one of three groups. For 14 days, one group took the antibiotic amoxicillin, the second took the antibiotic amoxicillin-clavulanate, and the third took an inactive substance. A pharmacist distributed the medications so no one knew what patients were in which group.

The researchers phoned each patient or caregiver seven times over the next two months to see if sinus symptoms were still present and if they were better or worse. Side effects of treatment, a relapse or recurrence of sinusitis and parent satisfaction with treatment also were noted.

Seventy-nine percent of the children on amoxicillin improved after 14 days, as did 81 percent of those on amoxicillin-clavulanate and 79 percent of those on the placebo. Side effects such as nausea and diarrhea were more common among the children taking an antibiotic, appearing in 19 percent of those on amoxicillin, 11 percent of those on amoxicillin-clavulanate and 10 percent of the placebo group.

Some patients who improved initially then relapsed after three or four weeks. Other patients' symptoms reappeared in the second month after treatment began. However there were no differences among the three groups.

"In a sense, we have met the enemy, and we are it," says Elliot Gellman, M.D., clinical professor of pediatrics. "Many people who come into the office say they are there to get antibiotics for sinus problems."
-end-
Gellman, who also is on the staff of St. Louis Children's Hospital, acknowledges the difficulty of changing the way pediatricians interact with patients and parents. "Giving an antibiotic is the quickest way to bring an appointment to an end," he says. "But it turns into a communication issue--something we should deal with."

Washington University School of Medicine

Related Antibiotics Articles from Brightsurf:

Insights in the search for new antibiotics
A collaborative research team from the University of Oklahoma, the Memorial Sloan Kettering Cancer Center and Merck & Co. published an opinion article in the journal, Nature Chemical Biology, that addresses the gap in the discovery of new antibiotics.

New tricks for old antibiotics
The study published in the journal Immunity reveals that tetracyclines (broad spectre antibiotics), by partially inhibiting cell mitochondria activity, induce a compensatory response on the organism that decreases tissue damage caused during infection.

Benefits, risks seen with antibiotics-first for appendicitis
Antibiotics are a good choice for some patients with appendicitis but not all, according to study results published today in the New England Journal of Medicine.

How antibiotics interact
Understanding bottleneck effects in the translation of bacterial proteins can lead to a more effective combination of antibiotics / study in 'Nature Communications'

Are antivitamins the new antibiotics?
Antibiotics are among the most important discoveries of modern medicine and have saved millions of lives since the discovery of penicillin almost 100 years ago.

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.

Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.

Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.

Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.

Read More: Antibiotics News and Antibiotics Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.