Antibiotic amoxicillin no help in treating acute rhinosinusitis

No significant difference was found in treating patients experiencing clinically diagnosed uncomplicated acute rhinosinusitis with antibiotic amoxicillin compared with patients who received placebo, according to a study in the February 15 issue of JAMA.

A total of 166 adults (36% male) were randomized to receive a 10-day course of amoxicillin (1,500 mg/d) or placebo, administered in 3 doses per day. Patients in both groups received a 5- to 7-day supply of symptomatic treatments for pain, fever, cough, and nasal congestion to be used as needed.

According to the study performed at the Washington University School of Medicine, St Louis, patients with acute rhinosinusitis reported no statistically significant differences in symptom improvement at day 3 (37% for amoxicillin group vs 34% for control group) or at day 10 (78% for amoxicillin group vs 80% for control group). At day 7, more participants treated with amoxicillin reported symptom improvement (74% for amoxicillin group vs 56% for control group).

The study findings support recommendations to avoid routine antibiotic treatment for patients with uncomplicated acute rhinosinusitis, according to the authors. Yet, antibiotic treatment for upper respiratory tract infections is often both expected by patients and prescribed by physicians.

The authors noted that patients with symptoms indicative of serious complications were excluded from this trial and would likely need a different management strategy.