Are antibiotic courses prescribed for sinus infection too long?

Bottom Line: Most antibiotic courses to treat an acute sinus infection in adults were 10 days or longer, even though the Infectious Diseases Society of America recommends five to seven days for uncomplicated cases.

Why The Research Is Interesting: Sinus infection (sinusitis) is the most common condition for which outpatient antibiotic treatment is prescribed. When antibiotics are indicated for treatment of bacterial sinusitis, a treatment duration in line with the Infectious Diseases Society of America's practice guidelines is an antibiotic stewardship opportunity to reduce the use of unnecessary antibiotics.

Who and When: Almost 3.7 million visits by adults to physicians where antibiotics were prescribed for acute sinusitis using a 2016 national index that is a sample of drug therapies prescribed by private practice physicians

What (Study Measures): Antibiotics were grouped as penicillins, tetracyclines, fluoroquinolones, cephalosporins, azithromycin or other; treatment duration in days was described for all antibiotic prescriptions, all antibiotic prescriptions excluding azithromycin, and antibiotic prescriptions by drug group

How (Study Design): This was a descriptive study, so the researchers did not gather information about underlying causes for the findings and cannot make conclusions about their medical significance

Authors: Laura M. King, M.P.H., of the Centers for Disease Control and Prevention, Atlanta, Georgia, and coauthors

Results: Overall, 69.6 percent of antibiotic therapies were prescribed for 10 days or longer. When prescriptions for azithromycin were excluded, 91.5 percent of antibiotic courses were 10 days or longer.

Study Limitations: Authors cannot account for underlying conditions or other reasons for longer courses of antibiotic treatment.

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For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamainternmed.2018.0407)

Editor's Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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