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Antibiotics for acute rhinosinusitis in adults
Marieke B Lemiengre1, Mieke L van Driel, Dan Merenstein
1Department of Family Medicine and Primary Health Care, Ghent University, Campus UZ 6K3, Corneel Heymanslaan 10, Ghent, Belgium, 9000.
The Cochrane Database of Systematic Reviews
|September 11, 2018
Summary
Antibiotics offer minimal benefit for acute rhinosinusitis, with only a slight increase in faster cures. The risks of side effects and antibiotic resistance outweigh the marginal advantages for uncomplicated cases.
Area of Science:
- Medical Research
- Infectious Diseases
- Clinical Trials
Background:
- Acute rhinosinusitis is a common infection of the nasal passages and sinuses, typically diagnosed clinically.
- Antibiotic use for acute rhinosinusitis is debated due to unclear benefit-harm balance.
Purpose of the Study:
- To assess the efficacy and safety of antibiotics versus placebo for acute rhinosinusitis in ambulatory care settings.
- To evaluate the impact of antibiotics on cure rates and adverse effects.
Main Methods:
- Systematic review and meta-analysis of 15 randomized controlled trials involving 3057 participants.
- Included trials compared antibiotics with placebo or no treatment for acute rhinosinusitis.
Main Results:
- Antibiotics showed a marginal benefit in faster cure rates (5-11 more per 100) but increased side effects (13 more per 100).
- Purulent secretion resolved faster with antibiotics, but serious complications were rare.
- Clinical failure rates were lower with antibiotics (5 fewer per 100).
Conclusions:
- The benefits of antibiotics for uncomplicated acute rhinosinusitis are marginal and do not outweigh the risks of adverse effects and antibiotic resistance.
- Antibiotics are not recommended for uncomplicated acute rhinosinusitis.
- Further research is needed for specific populations like children or immunocompromised individuals.
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