Are antibiotics overused in the treatment of acute sinusitis?

Updated: Apr 22, 2020
  • Author: Ted L Tewfik, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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A retrospective cohort study by Pynnonen et al, conducted at a single academic institution, suggested that antibiotics are being overused in the treatment of patients with mild acute sinusitis of short duration. The investigators found that 66% of such patients were being given antibiotics, with antibiotic use varying according to the individual provider, the provider’s specialty (with emergency medicine providers tending to use more antibiotics), and whether a medical trainee was present. [9]

A study by Bergmark and Sedaghat indicated that in the United States, the antibiotic prescription rate for cases of acute rhinosinusitis is over 50% by primary care providers (PCPs) and emergency departments (EDs), reporting that PCPs prescribed antibiotics to 57.0% of adults presenting with acute rhinosinusitis and that EDs prescribed antibiotics to 59.1% of such patients. Among pediatric patients, the rates for PCPs and EDs were 52.9% and 51.4%, respectively. The investigators did find, however, that PCPs in the Northeast United States were more likely to prescribe antibiotics for acute rhinosinusitis than were those in other parts of the country. [10]

A study by Fleming-Dutra et al found that, based on the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, sinusitis was responsible for 56 ambulatory antibiotic prescriptions per 1000 population in the United States, the highest rate of such prescriptions for a single diagnosis. [11]

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