Antibiotics for acute maxillary sinusitis in adults

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…Four recent systematic reviews of RCTs have compared the efficacy of antibiotics to that of placebo for ABRS. [173][174][175][176] The reviews found that antibiotics conferred a benefit, but it was small; cure rates at 7 to 15 days improved from 86% with placebo to 91% with antibiotics. This effect was sufficiently small that the number needed to treat with antibiotics to show improvement in 1 individual ranged between 11 and 15.…”

“…Many different antimicrobial agents are indicated for acute bacterial sinus infections, yet none has been found to have clearly superior clinical outcomes compared to the others. Multiple systematic reviews, 173,175 reviews with recommendations, 7,177 and CPGs 4,178 have thoroughly reviewed the scores of comparisons of differing antibiotics, differing dosages, and differing durations of therapy. The consensus of all of these analyses is that amoxicillin, either alone or with clavulanate, is the first antibiotic of choice in treating suspected ABRS.…”

Acute sinusitis and sore throat in primary care

“…3 Analysis of the trials found there was a 0.66 risk ratio (95% CI* 0.47-0.94) if antibiotics were used, which * CI confidence interval…”

Using Clinical Decision Support Within the Electronic Health Record to Reduce Incorrect Prescribing for Acute Sinusitis

“…1,2 Approximately 12% of the adult population in the United States is diagnosed with acute sinusitis annually, accounting for roughly 20% of all antibiotic prescriptions per year for adults in the primary care setting. 3,4 Bacterial sinusitis, however, only occurs in approximately 2%-10% of cases and usually results from a secondary infection 7-10 days after the initial viral infection has manifested.…”

“…The authors found that 80% of participants not treated with antibiotics improved within 2 weeks. 4 The investigators therefore argued that clinicians must carefully balance the limited benefit of antibiotic against potential adverse effects. Adverse effects of antibiotics include but are not limited to rash, diarrhea, and Clostridium difficile infection.…”