Current recommendations:
Current guidelines from the Infectious Diseases Society of America (IDSA) recommend only antibiotic treatment duration of 5 to 7 days in uncomplicated sinusitis. Recent findings from a research letter published in JAMA Internal Medicine, show that a significant number of antibiotic prescriptions for acute sinusitis are written for greater than10 days.
How the researches arrive at this conclusion:
Using the 2016 National Disease and Therapeutic Index (IQVIA), researchers identified an estimated 3,696,976 physician visits in which antibiotics were prescribed for a sinusitis. Patients were excluded if they had a concurrent antibiotic prescription for other conditions.
Results:
Results showed that the median duration of therapy for all antibiotics was 10.0 days with 69.6% of prescriptions given for ≥10 days (95% CI, 63.7%–75.4%). IDSA explicitly recommends against using azithromycin to treat sinusitis. After excluding azithromycin, the percentage of antibiotic courses that were given for over 10 days in duration jumped to 91.5%; 7.6% (95% CI, 4.1%-11.1%). Although the IDSA guidelines recommend against the use of azithromycin, 22.6% of prescriptions (95% CI, 17.2–28.0%) were for a 5-day course of azithromycin.
For patients at high risk or those who have failed initial treatment, 7 to 10 day courses of therapy may be appropriate, however it is unlikely those types of cases made up most patients in the study.
Based on their findings, the authors concluded that “the durations of most courses of antibiotic therapy for adult outpatients with sinusitis exceed guideline recommendations.
What is sinusitis?
Sinusitis an infection of your sinus that can cause by either a virus or a bacteria. For Viral sinusitis, antibiotics should not be use.
Why should we worry about duration of antibiotics in uncomplicated Sinusitis?
Because the number of antibiotic resistant infections is growing, and we do not have new antibiotics to treat those resistant infections. A recent article shows that inappropriate prescribing of antibiotics has remained the same.
