Antibiotics for acute maxillary sinusitis in adults
Anneli Ahovuo-Saloranta1, Ulla-Maija Rautakorpi, Oleg V Borisenko
1Finnish Office for Health Technology Assessment (FinOHTA), National Institute for Health and Welfare (THL), Tampere office, Finn-Medi 3, Biokatu 10, Tampere, Finland, FI-33520.
The Cochrane Database of Systematic Reviews
|February 12, 2014
Summary
Antibiotics offer a small benefit for acute sinusitis, but most patients improve without them. Clinicians should balance potential benefits against adverse effects when prescribing antibiotics for sinusitis.
Area of Science:
- Infectious Diseases
- Pharmacology
- Evidence-Based Medicine
Background:
- Sinusitis is a common diagnosis in adults, frequently leading to antibiotic prescriptions.
- The efficacy and necessity of antibiotics for sinusitis remain subjects of debate.
Purpose of the Study:
- To evaluate the effectiveness of antibiotics versus placebo in adults with acute maxillary sinusitis.
- To compare different antibiotic classes and their associated side effects.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases (CENTRAL, MEDLINE, EMBASE, etc.) without language restrictions.
- Included RCTs comparing antibiotics to placebo or other antibiotics for acute maxillary sinusitis.
Main Results:
- Antibiotics showed a small but statistically significant reduction in clinical failure rates at 7-15 days (moderate quality evidence).
- High cure/improvement rates (86-91%) were observed in both placebo and antibiotic groups.
- Adverse effects were more common with antibiotics, though drop-out rates were low.
Conclusions:
- Antibiotics provide a modest clinical benefit for uncomplicated acute sinusitis in primary care.
- Approximately 80% of patients improve within two weeks without antibiotics.
- Weighing the small benefits against potential adverse effects is crucial for clinical decision-making.
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