http://www.healthsentinel.com/org_news.php?event=org_news_print_list_item&id=029

Roman Bystrianyk, "Antibiotics are of Little or No Benefit for
Sinusitis", Health Sentinel, February 26, 2005,

Adults in the United States are estimated to have two to three colds
per year. Sometimes colds are complicated with sinusitis, which is an
infection of the sinus cavities that can be either caused by a virus or
bacteria. According to the United States Department of Health and
Humans Services, approximately 40 million Americans are affected by
sinusitis every year, with 33 million cases of chronic sinusitis
reported annually to the US Centers for Disease Control and Prevention.
Sinusitis is the fifth most common diagnosis for which antibiotics are
prescribed. More than $6 billion is spent annually on prescription and
over-the-counter medications treating this problem in the United
States.

Although only 0.5 to 2 percent of colds are complicated with bacterial
sinusitis, doctors still treat more than half of colds with
antibiotics. Although there are tests such as CT scans and sinus
puncture with culture that can more accurately determine which patient
has a bacterial infection it is considered impractical for primary care
physicians that usually treat these conditions. Because it is difficult
for physicians to determine which patients have bacterial infections,
they are in a dilemma as to which patients should receive antibiotics.

In the February issue of The Journal of Family Practice, the authors of
a study examined whether patients with sinusitis visiting a primary
care physician improve with antibiotics. They preformed a double-blind,
placebo-controlled study involving 135 patients. One group of 67
patients received amoxicillin and the other group of 68 patients
received a placebo.

The authors state that, "our findings are consistent with others in
which the overall benefit of antibiotics was minimal or nonexistent".
However, among a subset of individuals who received amoxicillin,
"improved much earlier, both clinically and statistically."
Although this small subset did improve the authors were unable to
determine beforehand who was likely to improve.

The authors conclude that, "patients diagnosed with clinical
sinusitis fared no better with amoxicillin or placebo, when measuring
the patient-oriented outcome of complete improvement." They note a
sub-group did improve with antibiotics but they could not in advance
identify people in this group. However, "using antibiotics in
patients unnecessarily would only cause potential individual and
society harm."

SOURCE: The Journal of Family Practice, February 2005