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Antibiotics for acute maxillary sinusitis.

J W Williams1, C Aguilar, J Cornell

  • 1Medicine, Durham Veterans Affairs Medical Center/ Duke University Medical Center, 508 Fulton Street, HSRD (152), Durham, NC 27705, USA. willi007@mc.duke.edu

The Cochrane Database of Systematic Reviews
|June 14, 2003
PubMed
Summary
This summary is machine-generated.

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Antibiotics like penicillin may improve acute maxillary sinusitis cure rates, but evidence is limited. Clinicians should balance benefits against potential adverse effects when prescribing antibiotics.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Sinusitis is a common diagnosis in ambulatory care settings, frequently treated with antibiotics.
  • The efficacy and optimal antibiotic class for acute maxillary sinusitis require further investigation.

Purpose of the Study:

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

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing antibiotic treatments for acute maxillary sinusitis.
  • Included studies required radiographic or sinus aspiration confirmation, clinical cure/improvement outcomes, and at least 30 adult participants.
  • Data from 49 trials involving 13,660 participants were analyzed.

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Main Results:

  • Penicillin demonstrated a statistically significant improvement in clinical cure rates compared to control (RR 1.72).
  • No significant differences in cure rates were observed between different antibiotic classes (newer non-penicillins vs. penicillins or amoxicillin-clavulanate).
  • Cephalosporins showed significantly fewer dropouts due to adverse effects compared to amoxicillin-clavulanate.

Conclusions:

  • Limited evidence supports the use of penicillin or amoxicillin for 7-14 days for radiographically confirmed acute maxillary sinusitis.
  • Clinicians should carefully consider the moderate benefits of antibiotic therapy against potential adverse effects.