Study questions drug treatments for sinus ills

Study questions drug treatments for sinus ills
CHICAGO (Reuters) - Common drug treatments for sinusinfections -- antibiotics and steroid nasal sprays -- seem tobe little better than doing nothing at all, British researcherssaid on Tuesday.
"Wide-scale overtreatment is likely occurring" becausethere is no proof many of these infections are bacterial innature, Dr. Ian Williamson of the University of Southampton andcolleagues wrote in their report.
Antibiotics are useless against viruses, a common cause ofsinus infections, and their overuse can lead to the developmentof drug-resistant bacteria.
The findings, published in this week's Journal of theAmerican Medical Association, came from a study of 240 adultswith sinus infections between 2001 and 2005.
Some of them were treated with the antibiotic amoxicillinand a nasal spray using the steroid budesonide in each nostril,others got one of those two drugs plus an inert placebo and athird group got two placebos.
After 10 days, 29 percent of those who got the antibioticstill had symptoms compared to 33 percent who did not get thatdrug, and 31 percent who got the spray were still havingproblems compared to 31 percent who did not receive it.
The report said the nasal spray did seem to help patientswho had less severe symptoms to start with.
"Our main conclusions are that among patients with thetypical features of acute bacterial sinusitis, neither anantibiotic nor a topical steroid alone or in combination areeffective in altering the symptom severity, the duration, orthe natural history of the condition," the researchers wrote.
"Topical steroids are likely to be effective in those withsuch features but who have less severe symptoms ..." theyadded.
Even though there is uncertainty about antibiotic use forsinus problems, prescription rates for such drugs for sinustreatment remain as high as 92 percent in the United Kingdomand 85 percent to 98 percent in the United States and are onlyslightly lower in Norway and Holland, the researchers said.
On top of that patients seem to think that antibiotics arethe way to go when it comes to sinus ills, they added.
In a commentary in the same issue, Dr. Morten Lindbaek ofNorway's University of Oslo said some studies indicate thattelling patients to wait a week or so before a prescription canbe filled seems to be one good approach as many patients windup feeling better and not filling the prescriptions.
"Most patients with acute purulent (with pus) sinusitisrecover without antibiotic treatment," he wrote. But in a fewcases patients suffering from fever, malaise and generaldeterioration may still need antibiotics, he added.
In general though, he said, "cautious use of antibiotics inthe general practice setting for patients with sinusitis iswarranted." (Reporting by Michael Conlon; editing by Maggie Foxand Eric Beech)