Doctors are unnecessarily prescribing antibiotics for sinus infections. According to the study published in the March issue of Archives of Otolaryngology-Head & Neck Surgery, US, antibiotics were prescribed for 82 per cent of acute sinus infections and nearly 70 per cent of chronic sinus infections.
This is a shocking finding as antibiotics can only kill bacteria and most sinus infections are caused by viruses, allergies or hormonal changes.
The study, by Hadley J. Sharp and colleagues at the University of Nebraska Medical Center, Omaha, US, used national data from 1999 and 2002 to determine the drugs that were prescribed for sinus infections by general practitioners, outpatient and emergency departments. The data came from 2 national surveys by the National Center of Health Statistics and was representative of the US population.
There are 2 types of sinus infections: acute and chronic. Acute sinusitis occurs for up to 4 weeks and is caused by infectious agents. Chronic sinusitis is usually defined as an infection with symptoms that are persistent for more than 12 weeks. It can be caused by allergies, hormonal changes or facial anatomy.
There are currently no effective drugs for chronic sinusitis. According to Dr. Donald A. Leopold, chairman of the department of otolaryngology at the University of Nebraska Medical Center, antibiotics are the best of a bad lot.
Many patients would call up their doctors and demand for specific antibiotics that may give them relief. They are aware of these drugs. They want prompt relief from the annoying symptoms of sinusitis. It's no wonder why doctors are giving in to their demands.
Although there are several tests to find out whether a sinus infection is caused by bacteria, they are often expensive and lengthy. The first test is an endoscopy, which involves inserting a small tube-like instrument into the nose to collect a sample of mucus from the sinus cavities. The second test is a nasal cytology, whereby a swab of mucus is taken from the lining of the nose to be examined. The third is taking an x-tray.
It is often difficult for doctors to determine the cause of a sinus infection just from observation. Even specialist doctors are not able to diagnose the specific cause without carrying out any tests. The symptoms of sinus infections are similar whether it's caused by bacteria, virus, allergy or other factors.
On the prevalent use of antibiotics, the researchers suggest that doctors could be treating secondary infections. Another possible explanation is doctors think that antibiotics work when their patients get better taking them. However, many infections resolve with or without treatment.
The researchers are concerned about the overuse of antibiotics giving rise to drug resistance and virulence of infectious bacteria. Although the public are aware of the increasing antibiotic resistance, many sinusitis sufferers are likely to continue demanding for antibiotics.
Yes, according to the study recently reported on by lead researcher Dr. Ian G. Williamson, MD, from the University of Southampton, England. Dr Williamson's study reported the rather startling result that patients with sinus infections who were treated with a course of amoxicillin, the most commonly prescribed antibiotic for treating sinus infections, were no more likely to be cured than those who took nothing at all. In fact, some of the patients in the test took not only a course of antibiotics, but also a nasal steroid spray as well. Dr. Williamson said: "Overall we think antibiotics have a pretty small effect, if there is one there at all".
For those of us who have a history of recurrent sinus infections and who have routinely been treated with amoxicillin for this condition, this comes as a shock. Although I came to the conclusion about seven years or so that pulsating nasal irrigation is the best thing one can do to both prevent and treat a sinus infection, this is still surprising. I remember the days when I had at least 3-4 sinus infections per year. In almost every case the doctor would prescribe antibiotics, usually amoxicillin. I recall feeling that two or three days after beginning the course of medication, things started to improve. Since then I have been taking a steroid spray nightly, and I know that if I forget to take it, I am generally far more congested during the night than normal. Thus the results of this study definitely go against my personal past experience.
I should note that since I discovered pulsating nasal irrigation by reading the book by the famous ENT, Dr. Murray Grossan, I have not been sick very much. According to Dr. Grossan the machine he invented, called the Hydro Pulse, sends jets or pulses of a saline solution into the nose at a certain frequency. This frequency is close to that which the cilia oscillate in a healthy human being. So the idea is to both clean out the bacteria, pollen, viruses, dust, or whatever has been inhaled into the nose while breathing, and also to get the cilia moving properly. I used to get colds and sinus infections at regular intervals, but since then I am almost never sick. I have come to believe that even people who do not have recurrent sinusitis would benefit from this daily regimen. There's no doubt the procedure would prevent millions of people coming down with colds each year, for example.
It is also clear that antibiotics in general have been largely abused. There are horror stories about antibiotic resistant bacteria which have developed because of the overuse of these drugs. In particular, many believe that the plethora of household cleaning products containing agents that kill bacteria which are on the market also contribute to the problem, rather than helping to solve it. The basic theory is that if some amount of bacteria survive the onslaught of antibiotics or antibiotic-enhanced cleaning agents, those bacteria will multiply and produce more bacteria which will also be capable of withstanding the effects of those antibiotics. And so on and so on. Once again, one reads reports these days of strains of bacteria that can withstand even the most enhanced antibiotics, some which were considered to be effective last resorts in years past.
Hopefully Dr. Williamson's study will bring this issue to the forefront of public discussion even more strongly than it has been considered in the past. In general it is becoming obvious that people should use antibiotics sparingly, both as medications and in everyday household products. Certainly for severe cases of sinusitis antibiotics will continue to play a significant role, but in many cases, it appears they are not needed and don't do much if any good.
Both Alvin Toh & Walter Ballenberger are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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