Antibiotics Overused For Sinusitis

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According to the CDC, 9 out of 10 acute sinusitis cases are caused by a virus, and antibiotics are not useful. When acute bacterial sinusitis is diagnosed, a 5 to 7-day course of antibiotics is recommended for most patients by the Infectious Diseases Society of America (IDSA). The IDSA recommends against the use of azithromycin due to the risk of antibiotic resistance. 

Prescription data for nearly 3.7 million outpatients who received antibiotics for acute sinusitis in 2016 were reviewed for treatment duration. In 70% of the cases, antibiotics were prescribed for 10 days or more. Azithromycin (5- day course) was prescribed 20% of the time, despite the IDSA recommendation against its use. When azithromycin prescriptions were excluded, only 8% of patients were prescribed antibiotics for the recommended duration of 5 to 7 days.

Improved antibiotic stewardship is needed to curb the use of antibiotics for sinusitis, and to ensure that the duration is not longer than recommended.

• King LM, et al. JAMA Intern Med; published online March 2018.


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