Review of antimicrobials for acute rhinosinusitis

Acute bacterial rhinosinusitis in adults is a common malady, with between 30 to 35 million cases a year.

These patients are seen by a range of practitioners, from primary care physicians to otolaryngologists.

Findings from a meta-analysis that examined the use of antibiotics for treatment of these patients are presented at the 2007 AAO-HNSF Annual Meeting & OTO EXPO. Researchers noted several interesting points revealed in their research, including that the natural course of acute rhinosinusitis in adults is more prolonged than traditionally thought. Only a small minority of patients are cured or report improvement after 3 to 5 days, even when treated with an antibiotic. A second finding showed that antibiotics do provide a benefit in regard to the number of patients improved or cured, but only 7 to 12 days after initiation of treatment with antibiotics. Before 7 days, antibiotics do not provide a significant advantage, compared to treating simply with a placebo. An additional finding is the significant frequency at which negative side effects, such as gastrointestinal upset and diarrhea, occur with antibiotic treatment.

Findings from the study may help to determine a natural history of acute rhinosinusitis in adults, and what to expect when antimicrobial therapy is administered.