According to recent guidelines, patients who have experiences sinusitits symptoms for 10 days or more should then wait another seven days — for a total of 17 days — to allow the infection to go away on its own. Only after that time should antibiotic therapy be used.
Bacterial sinusitis can cause facial pain, fever and nasal congestion — symptoms which often go away on their own in roughly the same amount of time it takes for antibiotics to treat.
The American Academy of Otolaryngology—Head and Neck Surgery Foundation recently published guidelines to back their recommendation for clinicians to practice "watchful waiting" for patients with sinusitis before prescribing antibiotics.
Richard Rosenfeld, MD, chairman of otolaryngology at SUNY Downstate Medical Center in Brooklyn summarized randomized controlled trials that found 86 percent of patients taking a placebo for acute bacterial sinusitis got better in one to two weeks, compared with 91 percent of those taking antibiotics.
Dr. Rosenfeld told The Wall Street Journal that the differences in outcomes were "statistically significant, but it really makes you question whether all these people need antibiotics."
Although fewer than 2 percent of viral infections eventually become bacterial sinusitits, physicians prescribe antibiotics for sinusitis patients about 90 percent of the time, according to Daniel Merenstein, MD, an associate professor of family medicine at Georgetown University Medical Center.
"If people would follow [the guidelines] it would be great because it would really decrease antibiotic resistance, which is such a big problem in the United States," Dr. Merenstein told WSJ.
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