Doctors should cut down on antibiotic prescriptions for
a common infection because the drugs do not work, researchers
A very large percentage of people with sinusitis and
treated by conventional methods are prescribed antibiotics.
But an analysis of nine trials published in The Lancet
shows the drugs make no difference even if the patient
has been ill for more than seven days.
Sinusitis is very common - often occurring after colds
or flu - with 1-5% of adults diagnosed every year.
The infection of the sinuses - small air pockets inside
the cheekbones and forehead - causes a high temperature,
pain and tenderness in the face and forehead, and a blocked
or runny nose.
Several guidelines advise doctors to prescribe antibiotics
only when the patient has been ill for seven to 10 days.
It has been thought that this length of illness may
indicate a bacterial rather than viral infection which
would be susceptible to antibiotics.
The latest research, which looked at how long 2,600
patients were ill before they received treatment, found
time of illness is not a good indicator of whether antibiotics
will be effective.
Because of side-effects, costs, and the risk of resistance,
antibiotics are not justified even if patients have been
ill for longer than a week, the researchers concluded.
The figures showed 15 patients would need to be treated
before one would be cured with antibiotics.
Study leader, Dr Jim Young, from the Basel Institute
for Clinical Epidemiology in Switzerland, said: "If a
patient comes to the GP and says they have had the complaint
for seven to 10 days that's not a good enough reason for
giving them the antibiotic."
He added it would be reasonable for GPs to advise patients
to come back if symptoms got worse or went on for another
The National Institute for Clinical and health Excellence
(NICE) published draft guidance this week advising GPs
not to prescribe antibiotics or issue delayed prescriptions
which patients can use if they do not get better.
Co-author, Dr Ian Williamson, a GP in Southampton and
researcher at Southampton University, said sinusitis was
a horrible condition and people expected to get antibiotics
from their GP to help them.
"Antibiotics really don't look as if they work.
"We have found that antibiotics aren't effective for
sore throats and ear infections but sinusitis, which is
similar, is the one that people are slightly more die
Professor Steve Field, chair of the Royal College of
GPs, said doctors had been working hard to reduce antibiotic
use for sinusitis in recent years but there was probably
still too many prescribed.
"This gives reassurance to GPs that even if patients
have specific symptoms, it's unlikely antibiotics are
going to make a dramatic difference."
He those suffering from the infection to relieve symptoms
with steam, paracetamol and rest.
"You don't need to see the GP unless you've been ill
for a week."