Sinus bug antibiotics ‘no good’
The latest research, which looked at how long 2,600 patients were ill before they received treatment, found time of illness is not a good indicator of whether antibiotics will be effective.
Because of side-effects, costs, and the risk of resistance, antibiotics are not justified even if patients have been ill for longer than a week, the researchers concluded.
The figures showed 15 patients would need to be treated before one would be cured with antibiotics.
Study leader, Dr Jim Young, from the Basel Institute for Clinical Epidemiology in Switzerland, said: “If a patient comes to the GP and says they have had the complaint for seven to 10 days that’s not a good enough reason for giving them the antibiotic.”
He added it would be reasonable for GPs to advise patients to come back if symptoms got worse or went on for another week.
These data will challenge primary care physicians. I have not read the details of the article, but I remain skeptical. The BBC news article states that antibiotics do not help tonsillitis, while in fact they do decrease the duration of symptoms if the tonsillitis is due to group A streptococcus.
They provide a NNT (number needed to treat) of 15 for benefit. Compared to many things we do, this may well be an acceptable NNT.
The problem with these studies, like all research, is that interpretation depends on our clinical biases. Will this study change practice? I doubt it. If we do not treat a patient with sinusitis and a fever and the infection worsens, what would a jury say?
Helen Parker
March 14th, 2008 / 1:16 pm
I recently went to a walk in clinic as I was suffering from a cold for 2 weeks, which had then progressed to a sinus infection. Symptoms included face and teeth ache, fever, blocked sinuses and generally feeling rotten. I did take antibiotics for 10 days. My symptome were much improved after one day! I don’t think I could have gone to work if I had not taken the antibiotics