Why not antibiotics?

A new report in the March issue of Archives of Otolaryngology Head and Neck Surgery, indicates that antibiotics are being prescribed unnecessarily to treat sinus infection.

Over prescribing antibiotics contributes to the growing problem of bacterial resistance.

"We as physicians don't have very good medications for chronic rhinosinusitis," said Dr. Donald A. Leopold, chairman of the department of otolaryngology at the University of Nebraska Medical Center. Leopold, who led the research team 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."

The report details the results of 2 nationwide studies.  Researchers found that between 1999 and 2002, patients made over 17 million visits to health-care providers in search of a sinus infection cure. 70 percent of patients who were suffering with chronic sinusitis received at least one type of antibiotic.

Antibiotics do not treat the sinusitis that is caused by viruses or allergies, and are not very effective against sinusitis caused by bacteria.  Often patients are feeling so bad when stricken with sinusitis that they pressure doctors for relief of their pain and discomfort, demanding an antibiotic prescription.  Pharmaceutical companies  are now marketing antibiotics directly to consumers, which further complicates the issue.  "Many patients call up and ask for specific antibiotics," Leopold said. "The patients know these names. They have been marketed to them, so they know the drugs are available."

The Centers for Disease Control and Prevention (CDC) recommends that doctors use "strict criteria for diagnosis" of sinusitis: runny nose or persistent cough lasting more than 10 to 14 days without improvement; or symptoms of acute sinus infection, including fever with nasal discharge, facial pain or tenderness, and swelling around the eyes. By urging physicians to use these criteria, the CDC hopes to reduce the number of unnecessary antibiotic prescriptions.

Over $2 billion is spent each year in the U.S. for over the counter medications for nasal and sinus disorders, and about $200 million on prescription medications.

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