Treating sinusitis

Don't rush to antibiotics

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Millions of people are prescribed antibiotics each year for sinusitis, a frequent complication of the common cold, hay fever, and other respiratory allergies. In fact, 15 to 21 percent of all antibiotic prescriptions for adults in outpatient care are for treating sinusitis. Unfortunately, most of those people probably don’t need the drugs. Here’s why:

The drugs usually don’t help.

Sinusitis can be uncomfortable. People with the condition usually have congestion combined with yellow, green, or gray nasal discharge plus pain or pressure around the eyes, cheeks, forehead, or teeth that worsens when they bend over. But sinus infections almost always stem from a viral infection, not a bacterial one—and antibiotics don’t work against viruses. Even when bacteria are responsible, the infections usually clear up on their own in a week or so. And antibiotics don’t help ease allergies, either.

They can pose risks.

About one in four people who take antibiotics have side effects, including stomach problems, dizziness, or rashes. Those problems clear up soon after stopping the drugs, but in rare cases antibiotics can cause severe allergic reactions. Overuse of antibiotics also encourages the growth of bacteria that can’t be controlled easily with drugs. That makes you more vulnerable to antibiotic-resistant infections and undermines the benefits of antibiotics for others

They’re usually a waste of money.

Antibiotics often aren’t very expensive, but any money spent on unnecessary drugs is money down the drain. And since patients often request prescriptions and doctors often comply, the total cost to the health-care system is substantial—at least $31 million a year.

So when are antibiotics necessary?

They’re usually required only when symptoms last longer than a week, start to improve but then worsen again, or are very severe. Worrisome symptoms that can warrant immediate antibiotic treatment include a fever over 101.5°F, extreme pain and tenderness over your sinuses, or signs of a skin infection, such as a hot, red rash that spreads quickly. When you do need antibiotics, the best choice in many cases is generic amoxicillin, which typically costs about $4 and is just as effective as more expensive brand-name antibiotics, such as Augmentin. Note that some doctors recommend CT scans when they suspect sinusitis. But those tests are usually necessary only if you have frequent or chronic sinusitis or you’re considering sinus surgery.

Using This Information

This information is provided for you to use in discussions with your health-care provider. The content is for educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Unfortunately, we cannot help you with individual medical questions. Always seek the advice of your physician or other qualified health-care provider with any questions you may have regarding a medical condition. Never disregard, avoid, or delay in obtaining medical advice from your doctor or other qualified health-care provider because of something you read in this report. Use of this report is at your own risk. Consumer Reports, the American Academy of Asthma, Allergy, & Immunology (AAAAI), the ABIM Foundation, and their distributors are not liable for any loss, injury, or other damage related to your use of this report.

The report is intended solely for consumers' personal, noncommercial use and may not be altered or modified in any way or used in advertising, for promotion, or for any other commercial purpose. Special permission is granted to organizations participating in the Consumer Reports consumer health communication program to disseminate free copies of this report in print or digital (PDF) formats to individual members and employees. Learn more at ConsumerHealthChoices.org or send an e-mail to HealthImpact@cr.consumer.org.

Published by Consumer Reports © 2012 Consumers Union of U.S., Inc.,101 Truman Ave., Yonkers, NY 10703-1057. Developed in cooperation with AAAAI for Choosing Wisely, a project of the ABIM Foundation. Portions of this report are derived from AAAAI's “Five Things Physicians and Patients Should Question” list. © 2012 AAAAI. All Rights Reserved.

Using This Information

This information is provided for you to use in discussions with your health-care provider. The content is for educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Unfortunately, we cannot answer individual medical questions. Always seek the advice of a physician or other qualified health-care provider with questions about any medical condition. Never disregard, avoid, or delay in obtaining medical advice from a health-care provider because of something you have read in this report. Use of this report is at your own risk. Consumer Reports, AAFP, the ABIM Foundation, Archives of Internal Medicine, and their distributors are not liable for any loss, injury, or other damage related to your use of this report.

The report is intended solely for consumers' personal, noncommercial use and may not be altered or modified in any way or used in advertising, for promotion, or for any other commercial purpose. Special permission is granted to organizations in the Consumer Reports health communication program to disseminate free copies of this report in print or digital (PDF) formats to individual members and employees. Learn more at ConsumerHealthChoices.org or send an e-mail to HealthImpact@cr.consumer.org.

Published by Consumer Reports © 2012 Consumers Union of U.S., Inc., 101 Truman Ave., Yonkers, NY 10703-1057. Developed in cooperation with AAFP. Portions are derived from AAFP's “Five Things Physicians and Patients Should Question” list. © 2012 AAFP. This list is based on the “The ‘Top 5’ Lists in Primary Care: Meeting the Responsibility of Professionalism,” the Good Stewardship Working Group, Arch Intern Med. 2011;171:1385-1390. “Top 5” Lists in Primary Care” were first published as part of the Less is More™ series in the Archives of Internal Medicine. ©2011 American Medical Association.

04/2012