Antibiotics little help for acute sinus infection finds study

Kathleen Blanchard's picture
Study finds antibiotics won't help acute sinusitis.

When do you need an antibiotic for a sinus infection? Dr Jane M Garbutt, firs study author and a research associate professor of medicine at the Washington School of Medicine said in a press release antibiotics should be used with caution and are often over-prescribed in the primary care setting to treat sinusitis. The result is increasing antibiotic resistance.


Because sinus infections are so common in the United States, Garbutt and colleagues wanted to see if antibiotics were any better than placebo for sinusitis that can cause headache, nasal mucous, cough, pain in the cheekbones and even dizziness.

Included in the study were 166 participants with in the St. Louis area with moderate, severe, or very severe symptoms lasting between 7 and 28 days. The researchers excluded anyone with chronic sinus infection with complications of ear or chest infection.

Two groups were studied. One received a 10-day course of either placebo or the antibiotic Amoxicillin. Both groups took medications to treat sinus symptoms such as fever, pain and cough.

After 3 days there were no changes in symptoms for either group. At day 7 the group given antibiotics self-reported a small change in sinusitis symptoms that Garbutt says wouldn’t be noticeable to a patient. However, the improvement disappeared by day 10.

Allergies and nasal deformities can lead to recurrent bouts of sinusitis, according to the American Academy of Allergy and Immunology, who also have some tips for dealing with sinus issues.

Non-drug treatments include breathing in hot moist air and using saline nose sprays.

Evaluation by an ear, nose and throat specialist (ENT) might be recommended to look for problems with the structure of the nose that could be surgically repaired.


Sinus inflammation and swelling can diagnosed with MRI or CT scan that may be important to rule out other causes of headache, fever, pain or other symptoms.

Allergy medications and decongestants to open the nasal passages might be of benefit. Your doctor might prescribe steroid nasal sprays or medications to thin mucous that collects in the sinus passages.

People with allergies are more prone to develop sinusitis. Allergy testing and immunization is an option that can improve quality of life for anyone suffering from frequent sinus infection, and is guided by seeing an allergy specialist.

Sometimes a cold that affects the sinus cavities can turn into a bacterial infection. Symptoms that last more than 3 months might require antibiotics. The new study shows antibiotics are no better than taking a placebo for acute sinusitis, defined by the AAAI as lasting less than four weeks.

JAMA: doi: 10.1001/jama.2012.138
“Amoxicillin for Acute Rhinosinusitis
Jane M. Garbutt, MBChB et al.
February 15, 2012

Sinusitis: Tips to Remember

Image credit: Wikimedia commons

Updated October 25, 2013



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