Antibiotics for acute maxillary sinusitis

Ahovuo-Saloranta, Anneli; Rautakorpi, Ulla-Maija; Borisenko, O.; Liira, Helena; Williams, John W; Mākelä, Marjukka

doi:10.1002/14651858.cd000243.pub2

Cited by 143 publications

(89 citation statements)

References 150 publications

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“…Previous metaanalyses of the effect of antibiotics in acute rhinosinusitis showed different results when radiologic assessment was part of the inclusion criteria, compared with clinical diagnosis alone. 11,31 However, almost all patients with acute rhinosinusitis are seen in primary care, and radiologic imaging is not routinely performed in this setting before treatment decisions. Inclusion of pa tients based on radiologic assessment would therefore have strongly reduced the generalizability of our findings.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial

Venekamp

Bonten

Rovers

et al. 2012

CMAJ

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Section: Strengths and Limitationsmentioning

confidence: 99%

Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial

Venekamp

Bonten

Rovers

et al. 2012

CMAJ

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“…[1][2][3][4][5] Excessive antibiotic use for ARTIs is concerning, because there is little evidence of individual patient benefit from such therapy and strong evidence of increased antibiotic resistance and healthcare costs. [6][7][8][9][10] With increasing antibiotic resistance and few new agents under development, antibiotic stewardship has become a national health priority. 11 A number of interventions to reduce unnecessary antibiotic prescribing have been evaluated, including media campaigns, physician education, practice guidelines, chart reminders and audit and feedback systems.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Procalcitonin-Guided Antibiotic Therapy for Outpatient Management of Acute Respiratory Tract Infections in Adults

et al. 2013

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BACKGROUND:Two clinical trials suggest that procalcitonin-guided antibiotic therapy can safely reduce antibiotic prescribing in outpatient management of acute respiratory tract infections (ARTIs) in adults. Yet, it remains unclear whether procalcitonin testing is cost-effective in this setting. OBJECTIVE: To evaluate the cost-effectiveness of procalcitonin-guided antibiotic therapy in outpatient management of ARTIs in adults. DESIGN: Cost-effectiveness model based on results from two published European clinical trials, with all parameters varied widely in sensitivity analyses. PATIENTS: Two hypothetical cohorts were modeled in separate trial-based analyses: adults with ARTIs judged by their physicians to require antibiotics and all adults with ARTIs. INTERVENTIONS: Procalcitonin-guided antibiotic therapy protocols versus usual care. MAIN MEASURES: Costs and cost per antibiotic prescription safely avoided. KEY RESULTS: We estimated the health care system willingness-to-pay threshold as $43 (range $0-$333) per antibiotic safely avoided, reflecting the estimated cost of antibiotic resistance per outpatient antibiotic prescribed. In the cohort including all adult ARTIs judged to require antibiotics by their physicians, procalcitonin cost $31 per antibiotic prescription safely avoided and the likelihood of procalcitonin use being favored compared to usual care was 58.4 % in a probabilistic sensitivity analysis. In the analysis that included all adult ARTIs, procalcitonin cost $149 per antibiotic prescription safely avoided and the likelihood of procalcitonin use being favored was 2.8 %. CONCLUSIONS: Procalcitonin-guided antibiotic therapy for outpatient management of ARTIs in adults would be cost-effective when the costs of antibiotic resistance are considered and procalcitonin testing is limited to adults with ARTIs judged by their physicians to require antibiotics.

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“…20 The most recent Cochrane update emphasised that antibiotics have a limited treatment effect in acute rhinosinusitis and stated that most cases will resolve without antibiotics within 2 weeks. 21 Our interpretation of the data is that, in contrast to medical evidence and recent guidelines, there still seems to be a general view among GPs that mild to moderate acute rhinosinusitis is the result of a bacterial infection.…”

Section: Interpretation Of Findings In Relation To Previously Publishmentioning

confidence: 90%

High costs and burden of illness in acute rhinosinusitis: real-life treatment patterns and outcomes in Swedish primary care

Stjärne

Odebäck²,

Ställberg³

et al. 2012

Primary Care Respiratory Journal

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Antibiotics for acute maxillary sinusitis

Cited by 143 publications

References 150 publications

Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial

Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial

Cost-Effectiveness of Procalcitonin-Guided Antibiotic Therapy for Outpatient Management of Acute Respiratory Tract Infections in Adults

High costs and burden of illness in acute rhinosinusitis: real-life treatment patterns and outcomes in Swedish primary care

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