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    Sinus Infection? Antibiotics No Help

    Antibiotics, Steroid Spray No Help for Adult Sinus Infections


    A decade ago, a carefully controlled study by Norwegian sinusitis expert Morten Lindbaeck, MD, PhD, at the University of Oslo showed that antibiotics had a detectable effect on bacterial sinus infections -- but that the effect is quite modest.

    "Even in these very strict cases with a large probability that patients had really tough bacterial infections, more than half of patients were healthy by 10 days," Lindbaeck tells WebMD. "Even if you have a real bacterial infection, most of the time you get well without antibiotics."

    What about people who don't get better? That remains a question.

    "If they come to me and say, 'I have been sick for seven days and feel very bad and have a fever,' I start antibiotics right away. But that is the few," Lindbaek says. "The large majority of patients with sinus infections are not very sick. They have pain, they are stuffy, they don't feel well enough to go to work, but they are not very ill."

    What's wrong with just giving patients antibiotics? Williamson and Lindbaek both note that bacteria are becoming more and more resistant to antibiotic drugs. And antibiotics that are not effective spur the growth of drug-resistant bugs.

    Lindbaek says that more cautious prescribing policies among Norwegian doctors is one reason Norway has one-tenth as many important drug-resistant bacteria as does the U.S.

    And Williamson says patients and doctors should think about the future.

    "It is a green issue," he suggests. "Maybe we will get away with overusing antibiotics, but will our kids get away with it? We should use antibiotics wisely. It is a resource we don't want to use up."

    Williamson and colleagues report their findings in the Dec. 5 issue of The Journal of the American Medical Association. An editorial by Lindbaek appears in the same issue.

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