NEW YORK (Reuters Health) – Adults with sinusitis derive no benefit from antibiotic treatment with amoxicillin-potassium clavulanate, results of a Swiss study suggest.
Antibiotics are widely prescribed for adults who develop sinusitis, according to Dr. Heiner C. Bucher from the Basel Institute for Clinical Epidemiology and colleagues, but it is not clear whether these drugs improve the outcome of these patients.
In the Basel Sinusitis Study, researchers assigned 252 adults with a 48-hour history of nasal discharge and sinus pain to a combination product containing 875 mg amoxicillin and 125 mg clavulanic acid or to placebo, or “sugar pill,” twice daily for 6 days. All patients also received acetaminophen (Tylenol) and a decongestant.
There was no difference in the time to recovery between active treatment and placebo group, the team reports in the journal Archives of Internal Medicine.
Specifically, at one week, 29.8 percent and 30.7 percent of patients in the amoxicillin/clavulanate and placebo groups, respectively, were cured. At two weeks, the cure rates were 76.6 percent and 74.0 percent, respectively.
There were also no between-group differences in the number of days that illness restricted activities at home or work.
However, patients treated with amoxicillin/clavulanate were significantly more likely to have diarrhea, at both week one and two. There was also a trend toward more abdominal pain and vaginal discharge in the active treatment group.
“Antibiotics should not be given at first to patients with acute rhinosinusitis,” Bucher and colleagues write. They add that such a policy should help curb the emergence of antibiotic-resistant strains and reduce costs.
The researchers acknowledge that “some individual patients profit from antibiotic therapy,” but “whether these individuals can be identified by clinical tests…has yet to be shown.”