Don't Prescribe Antibiotics for Adult Sinus Woes

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The findings only apply to adult patients because children were not included in the study, the researchers stressed.

However, one otolaryngologist said the study goes too far in banning antibiotics for adult cases.

"This study should not convey the message that antibiotics are not indicated for all patients with sinusitis," Dr. Jordan S. Josephson, of Lenox Hill Hospital in New York City, said in a statement. He believes that while the drugs are certainly ineffective against viral sinusitis, they can offer patients with acute bacterial infections "significant symptom relief and improvement."

Josephson notes the study does not address "the 30-plus million Americans that suffer from chronic sinusitis." He said the evidence is clear that many patients with these longer-term sinus problems do benefit from antibiotic therapy.

However, the new findings mirror those of a study published last March in the Archives of Otolaryngology Head and Neck Surgery. That study found that U.S. doctors are consistently overprescribing antibiotics for sinus infections.

But even the physician who led that research doesn't see how the problem can be eliminated.

That's because when it comes to treatments for sinus trouble, antibiotics are the best of a bad lot, said Dr. Donald A. Leopold, chairman of the department of otolaryngology at the University of Nebraska Medical Center.

"We as physicians don't have very good medications for chronic rhinosinusitis," he said. "The only other drugs in contention are topical steroids, and they are not great. As a group, I suggest we are frustrated at not having good drugs. It would be great if we had better medications for this chronic inflammation."

Another factor is what patients demand, Leopold said. "Many patients call up and ask for specific antibiotics," he said. "The patients know these names. They have been marketed to them, so they know the drugs are available. And antibiotics do give some relief."

According to the Archives of Otolaryngology Head and Neck Surgery report, two national studies showed that Americans made more than 17 million visits to health-care facilities for sinus infections between 1999 and 2002. At least one antibiotic was prescribed in nearly 83 percent of cases of acute rhinosinusitis and in nearly 70 percent of cases of the chronic, longer-running version of the condition, in which symptoms persist for at least 12 weeks.