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Antimicrobial Prescription Patterns for Acute Sinusitis 2015-2022: A Comparison to Published Guidelines.

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American Journal of Rhinology & Allergy
|September 13, 2024
PubMed
Summary

Physician antibiotic prescribing for acute rhinosinusitis (ARS) frequently deviates from guidelines. Amoxicillin-based therapies are recommended, but macrolides are often overused, potentially increasing antibiotic resistance.

Keywords:
acute rhinosinusitisantibioticsantimicrobial stewardshipantimicrobialsclinical practice guidelinesotolaryngologyprescription patternsrhinologysinusitis

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pharmacology

Background:

  • Acute rhinosinusitis (ARS) is a common condition in primary care and otolaryngology.
  • Current antibiotic prescribing practices for ARS are not well understood in relation to established guidelines.

Purpose of the Study:

  • To examine the epidemiology of ARS.
  • To evaluate antibiotic prescribing patterns for ARS.
  • To compare prescribing practices against 2015 American Academy of Otolaryngology guidelines.

Main Methods:

  • Utilized the TriNetX Live database for patient identification (ICD10 code J01).
  • Analyzed data from April 2015 to December 2022 in Tennessee.
  • Compared initial antibiotic prescriptions within one day of ARS diagnosis to guidelines.

Main Results:

  • 81,310 ARS patients were identified; 69.8% received antibiotics within one day.
  • Amoxicillin/clavulanate (25.3%) and amoxicillin (16.4%) were prescribed, but macrolides (25.8%) were most common.
  • Only 42.2% of antibiotic prescriptions adhered to guideline recommendations.

Conclusions:

  • Physician adherence to ARS antibiotic guidelines is suboptimal.
  • Overreliance on macrolides, despite resistance concerns, is prevalent.
  • Increased physician awareness and further research into prescribing patterns are recommended for improved antibiotic stewardship.