We do not practice, but we know it, "he says.

(Health. com)

-- About 20% of antibiotics are written in U.S. adults each year for the nasal sinuses. This startling statistic given that doctors and public health officials long doubted that antibiotics can successfully treat the disease. a new study published this week in the Journal of the American Medical Association seems to confirm these concerns: antibiotic amoxicillin was no better than placebo at improving congestion, cough, runny nose, pain and other symptoms that accompany the sinuses (also known as acute sinusitis) , researchers found. "Compared with placebo, amoxicillin does not seem to provide any advantage," says lead author Jane Garbutt, an associate professor in the School of Medicine Washington University in St. Louis. "In terms of satisfaction of patients, side effects, relief of symptoms, days missed from work, and so on, we did not see any difference. "

Most sinus infections are caused by viruses that do not respond to antibiotics. But even bacterial infections sinus rarely require treatment with antibiotics, according to the Centers for Disease Control and Prevention. In most cases, both types of infection to go by themselves in less than two weeks. " Most patients better, despite the antibiotics, not because they are, "says Garbutt. "There is a high rate of spontaneous resolution. "Antibiotics

would be more useful if doctors were able to differentiate between viral and bacterial rhinosinusitis. But general practitioners do not have tests at their disposal, reliably diagnose bacterial infections, Garbutt said in a study she and her colleagues were unable to detect signs or other markers that predict which patients will respond to antibiotics. "The problem for doctors primary is figuring out which patients will benefit," she says. The study included 166 people with moderate or severe sinus infection. Half of the participants took amoxicillin three times a day for 10 days and the other half received placebo in the same way. In addition, each patient received acetaminophen, cough medicine, decongestants and use as needed. Two groups of patients improved by about the same rate. On the third day, just over one-third of those in each group reported symptom relief, proprotion which increased to approximately 80% in each group of 10-th day. patients receiving antibiotics experienced significantly better than placebo on the seventh day, but researchers do not believe the difference in clinical (as opposed to statistical) significant in that day, the difference in the two groups of life -. as measured by the extent relevant name snot-16 -. was small, the study noted, the results confirm what many doctors suspected, even if they continue to prescribe antibiotics for sinusitis patients, says Daniel Merenstein, MD, assistant professor of family medicine at Georgetown University Medical Center, Washington, DC " We do not practice, but we know it, "he says. "This study can help us produce fewer antibiotics. "

The main reason doctors continue to prescribe antibiotics that patients expect them, Garbutt and her colleagues. One way to meet the patients without excessive use of antibiotics, Garbutt said, is to give them the recipe, but I advise them not to fill it unless symptoms persist or worsen - .. protocol, which became popular in Europe Garbutt said that it is also very important that doctors tell their patients about what procedures work, which do not, and why "you should have some connection plan," she says . "You must provide information about what they should expect and what to do if their condition worsens. "

Waiting for the patient not only the driver of antibiotics for sinus infections, but Mark Shikowitz, MD, director Zucker nasal sinuses and the Center for North Beach -. Long Island Jewish Health System, New Hyde Park New York, said that some doctors prescribe drugs to protect against a very rare chance that the sinusitis will develop into something much worse, such as brain abscess, a bunch of cells that can develop after a bacterial infection. "Likely very small, but the result, if this happens can be catastrophic", Shikowitz says. " And for every bad result of medical negligence lawyer. "

Some doctors do not want to refuse or repel antibiotics to medical organizations formally adopt a conservative approach, supported by Garbutt and her colleagues as a new standard of care, he says. Excessive use of antibiotics for sinusitis has strattera 10mg important health implications in light of growing concerns about antibiotic-resistant bacteria and viruses. Widespread use of antibiotics can cause infectious organisms that cause disease adapt protection, making the drug less effective in the population as a whole. Copyright.