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Antibiotics Overused for Sinusitis

Most Sinus Problems Caused by Viruses, Inflammation

Inhaled Steroids and Saline Sprays

Ear, nose, and throat specialist Michael Benninger, MD, tells WebMD that the overprescribing of antibiotics is largely driven by patient expectations.

He points out that in Europe, antibiotics are rarely prescribed for sinus infections.

“In this country, I really don’t think we have gotten to the point where we tell patients they don’t need antibiotics.”

Benninger adds that he is somewhat surprised by the latest findings, given the concerns about antibiotic overuse spurring resistance to the drugs.

“The bottom line is we should not be treating a virus with an antibiotic, and we should not assume that antibiotics are the best treatment for acute or chronic rhinosinusitis,” he says.

Inhaled steroids, used to reduce inflammation, appear to be a better approach for many patients with chronic sinus problems, he adds.

But this treatment was prescribed only 16.4% of the time to patients in the study with chronic symptoms.

Leopold and Benninger agree that one of the best treatments for nonbacterial acute sinus infections is also one of the simplest.

Flushing the nose frequently with a saline nasal spray is a highly effective, over-the-counter therapeutic approach, Leopold says. He recommends that patients start using saline sprays when they feel upper respiratory symptoms coming on.

“My patients are sick of hearing about this, but saline therapy is cheap, effective, and underutilized,” he says.

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