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Antibiotics for acute maxillary sinusitis.

J W Williams1, C Aguilar, M Makela

  • 1Medicine, South Texas Veterans Health Care System, Audie Murphy Division, 7703 Floyd Curl Drive, Mail Stop 7879, San Antonio, TX 78229-3900, USA. jwilliam@verdict.uthscsa.edu

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary
This summary is machine-generated.

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Antibiotics show moderate benefit for acute maxillary sinusitis, with penicillin or amoxicillin recommended for 7-14 days. Clinicians should balance treatment benefits against potential adverse effects.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pharmacology

Background:

  • Sinusitis is a common diagnosis in ambulatory care, frequently treated with antibiotics.
  • The efficacy of antibiotic therapy for acute sinusitis requires further investigation.

Purpose of the Study:

  • To determine if antibiotics are indicated for acute sinusitis.
  • To identify the most effective antibiotic classes for treating acute maxillary sinusitis.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Included studies required radiographic or sinus aspiration confirmation, clinical cure/improvement outcomes, and ≥30 adult participants.
  • Searched MEDLINE and EMBASE databases; 32 trials involving 7,330 subjects were included.

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Main Results:

  • Penicillin demonstrated improved clinical cure rates compared to control (RR 1.72).
  • No significant differences in cure rates were observed between antibiotic classes (e.g., newer non-penicillins vs. penicillins).
  • Antibiotic treatment improved radiographic outcomes, but dropouts due to adverse effects were lower for cephalosporins compared to amoxicillin-clavulanate.

Conclusions:

  • Limited evidence supports penicillin or amoxicillin for 7-14 days for radiographically confirmed acute maxillary sinusitis.
  • The moderate benefits of antibiotic treatment must be weighed against potential adverse effects.
  • Further research is needed to optimize antibiotic selection and duration for acute sinusitis.