Acute sinusitis and sore throat in primary care

Area of Science:

• General Practice
• Infectious Diseases
• Pharmacology

Background:

• Diagnosing sore throat and acute sinusitis can be challenging, often leading to empirical treatment decisions.
• The role of pathogen identification versus evidence-based guidance in managing these common conditions is debated.

Approach:

• This analysis reviews the empirical evidence for antibiotic use in sore throat and acute sinusitis.
• It considers the balance between the limited benefits and potential harms of antibiotic therapy.

Key Points:

• Antibiotics provide very limited benefits for acute upper respiratory tract infections like sore throat and sinusitis.
• Potential harms include diarrhea, rash, and thrush, alongside the significant risk of developing antibiotic resistance.
• Evidence-based guidance and shared decision-making are recommended for prescribers.

Conclusions:

• Antibiotic prescribing for sore throat and acute sinusitis should be guided by empirical evidence, not solely pathogen guessing.
• Shared decision-making between general practitioners (GPs) and patients is essential to weigh the minimal benefits against the harms of antibiotics.
• Minimizing unnecessary antibiotic use is critical to combat the growing threat of antibiotic resistance.