Physician adherence to acute rhinosinusitis antibiotic treatment guidelines

Antibiotic treatment guidelines promote proper diagnosis and treatment and optimize antibiotic treatment, minimizing both antimicrobial resistance to antibiotics and financial expenditure. This study aimed to investigate whether community physicians and emergency department (ED) physicians diagnose and treat acute rhinosinusitis according to accepted guidelines. This was a retrospective study of medical records and referrer letters of patients admitted to the medical center between 2014 and 2015. Physician adherence to antibiotic guidelines regarding indication, type and duration of treatment was assessed. Overall, the study included 84 patients diagnosed with acute rhinosinusitis and admitted to the ED. Fewer than 20% of doctors treating patients with rhinosinusitis at our institution followed the current recommended guidelines. In most cases, the type of treatment administered by ED physicians and by community physicians complied with the guidelines (90% and 96%, respectively, p=0.564). The duration of treatment prescribed by the ED physicians aligned with the guidelines in 37.7% of the cases. There was insufficient compliance with acute rhinosinusitis treatment guidelines among all treating physicians in this study, which was characterized by excessive antibiotic treatment. Therefore, ways to increase understanding and adherence to clinical guidelines, and to provide optimal settings in the clinics to carry out the guidelines should be investigated.