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Most children with acute sinusitis recover without antibiotics

St. Louis, April 2, 2001 Antibiotics do not help most children with acute sinusitis, according to a study to be published in the April issue of Pediatrics. This finding raises questions about the common practice of prescribing antibiotics to children with long-lasting sinus symptoms.

"Most children with prolonged cold-like symptoms suggestive of acute sinus disease get better within three weekswithout antibiotic therapy," says Jane Garbutt, M.B., Ch.B., instructor of medicine at Washington University School of Medicine in St. Louis. "Our study suggests that, for children with uncomplicated acute sinusitis, it makes sense to delay antibiotic treatment and watch carefully." Garbutt emphasized that it still is important for children to visit their pediatrician to rule out more serious illness, even if antibiotics are not prescribed.

"Antibiotics are expensive and can cause side effects, most commonly diarrhea," Garbutt says. "Another concern is that they are an important factor in the emergence and spread of antibiotic-resistant bacteria."

The researchers studied 180 pediatric patients aged 1 to 18 whose sinus symptoms had persisted for 10 to 28 days. Once the patients were clinically diagnosed with acute sinusitis, they were assigned randomly to one of three groups. For 14 days, one group took the antibiotic amoxicillin, the second took the antibiotic amoxicillin-clavulanate, and the third took an inactive substance. A pharmacist distributed the medications so no one knew what patients were in which group.

The researchers phoned each patient or caregiver seven times over the next two months to see if sinus symptoms were still present and if they were better or worse. Side effects of treatment, a relapse or recurrence of sinusitis and parent satisfaction with treatment also were noted.

Seventy-nine percent of the children on amoxicillin improved after 14 days, as did 81 percent of those on amoxicillin-clavulanate and 79 percen
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Contact: Anne Enright Shepherd
shepherda@msnotes.wustl.edu
314-286-0119
Washington University School of Medicine
1-Apr-2001


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