Kids' Sinusitis Might Not Need Antibiotics
Doctors can 'watch and wait' for an additional 3 days
By Dennis Thompson
MONDAY, June 24 (HealthDay News) -- Doctors don't have to automatically prescribe an antibiotic to treat children who appear to have acute sinus infections, according to new guidelines issued by a leading group of pediatricians.
Instead, they can take a "watch and wait" approach if it appears the infection might clear on its own, according to the new American Academy of Pediatrics guidelines.
"The practitioner can either treat immediately or consider waiting for a couple of days," said Dr. Ellen Wald, chairwoman of the academy's subcommittee on acute sinusitis. "If the kid doesn't look dramatically ill, you can wait an extra couple of days to see if they improve on their own."
The previous guidelines, passed in 2001, recommended antibiotic therapy for all children diagnosed with acute bacterial sinusitis, which is defined as persistent signs of sinus infection lasting more than 10 days.
Doctors now can observe kids for up to an additional three days past that 10-day period to see if their symptoms will ease without antibiotic treatment.
"There's nothing absolutely sacred about 10 days. It could be 11 days. It could be 12 days," said Wald, chairwoman of pediatrics at the University of Wisconsin School of Medicine and Public Health, in Madison. "In the child who looks sicker, we wouldn't do that. We would start on antibiotics immediately."
The new guidelines, published online June 24 in the journal Pediatrics, are driven primarily by concern over antibiotic resistance, she said. There is a lot of overlap between the common cold and acute sinusitis, and some children who are not suffering from a bacterial infection may be receiving antibiotics.
"If we prescribe fewer antibiotics, then the problem of antibiotic resistance is controlled," Wald said. "If you can avoid the use of antibiotics, then that is reasonable."
Between 6 percent and 7 percent of children who visit doctors seeking care for a respiratory condition have acute sinusitis, according to the report.
Most cases of acute sinusitis develop from a common cold. Colds usually last five to seven days and peak within two or three days, Wald said.