Antibiotics May be Over-prescribed for Sinus Infections

Filed in archive Cases , Treatment on March 25, 2007

An inflammation of the sinus cavities - rhinosinusitis which is commonly referred to as a sinus infection is a common but expensive condition in the United States.

The infection is considered acute when symptoms last up to four weeks, and chronic when symptoms persist for 12 weeks or longer. Acute rhinosinusitis is usually thought to be caused by infectious agents, while allergies, facial anatomy and hormonal changes may contribute to chronic cases.

We've been told (or we already know) that antibiotics are prescribed to conditions mainly caused by bacteria. However, according to a report in the March issue of Archives of Otolaryngology--Head & Neck Surgery (one of the JAMA/Archives journals), despite the fact that viruses are the most frequent cause of acute sinus infections and chronic sinus infections, antibiotics are prescribed in approximately 82% and 70% of each condition, respectively.

Such were the findings from a data analysis of two national surveys which assessed the medications prescribed for sinus infections at physicians' offices and hospital outpatient and emergency departments between 1999 and 2002.

According to the authors, led by Hadley J. Sharp, B.S. the University of Nebraska Medical Center, Omaha, data from the survey revealed:

"The most frequently recommended medications for treatment of both acute and chronic rhinosinusitis are antibiotic agents, followed by antihistamines; nasal decongestants; corticosteroids; and antitussive, expectorant and mucolytic agents, respectively.

Prescription antibiotic drugs are being used far more than bacterial causes studies would indicate. Nasal and inhaled corticosteroids are prescribed more frequently to treat acute rhinosinusitis than published studies imply is necessary."

With such statistics, concerns on overuse of antibiotics arise with problems resulting to drug resistance and increasing virulent bacteria. While some physicians would have treated secondary infections in some sinus infection cases, there may be cases when patients got better with the antibiotics but would have gotten better anyway without the treatment.

This all brings us to when antibiotics are truly necessary and when do physicians draw the line between a virus-caused and bacterial-caused sinus infection. But wait, sinus infections are caused by viruses, right?

Read the full report.

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