ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Evidence-Based Sinusitis

by Jill U. Adams • July 5, 2012

  • Tweet
  • Email
Print-Friendly Version

The infectious disease group guidelines, however, discuss the lack of stringent criteria used in the studies. Most of the clinical trials comparing

You Might Also Like

  • Antibiotics for Sinusitis: To Use or Not to Use?
  • Evidence-Based Medicine Comes to Otolaryngology
  • Hoarseness Guidelines Continue to Draw Scrutiny: Panel members question evidence-based criteria
  • A New Direction for Sleep: New OSA guidelines fuel another evidence-based medicine debate
Explore This Issue
July 2012

antibiotics to placebo enrolled patients with seven to 10 days of symptoms. Therefore, as the IDSA reasoning goes, it’s likely that a good proportion of participants in the clinical trials had viral sinusitis (even at 10 days, the percentage of viral illness in adults may be 40 percent), which would not respond to antibiotics, would resolve spontaneously and would muddy the data. Therefore, the IDSA guidelines state unequivocally that once bacterial involvement is diagnosed, withholding or delaying antibiotics is not recommended.

Other reviews of the clinical trial data have concluded that watchful waiting is warranted for most patients, even after 10 days of symptoms. An international team did a meta-analysis of nine clinical trials in which participants were randomly assigned to antibiotic treatment or placebo. Importantly, the team didn’t just average aggregate data but, rather, obtained individual subject data from the trials with the specific aim to identify particular clinical signs or symptoms that predicted a response to antibiotic treatment (Lancet. 2008;371(9616):908-914).

Not only did the group conclude that antibiotics offer little benefit for adults with acute sinusitis, but also, the meta-analysis authors wrote: “Antibiotics are not justified even if a patient reports symptoms for longer than seven to 10 days.”

It’s one thing to analyze the studies and make recommendations, however, and another thing entirely to be in the primary care office. “No one waits ten days—not the patients, not the doctors,” said Dan Merenstein, MD, coauthor of the Lancet study and assistant professor and director of research programs in the department of family medicine at Georgetown University School of Medicine in Washington, D.C. He quoted the statistic that more than 80 percent of people who seek treatment get antibiotics (Fam Med. 2006;38:349-354).

“It is hard to change behavior,” said Stephen Smith, MD, MPH, professor emeritus of family medicine at Brown University’s Alpert Medical School in Providence, R.I. Dr. Smith has led the National Physicians Alliance efforts to develop priorities in primary care settings for improving quality and reducing risks and costs of care. Treating mild to moderate sinusitis was number two on the family medicine list.

“I’m optimistic that we’ve reached a point where the culture is ready for change,” Dr. Smith said. Toward that end, Dr. Smith has worked at educating both patients and doctors that symptomatic relief, not antibiotics, is the standard of care.

Pages: 1 2 3 4 5 | Single Page

Filed Under: Articles, Clinical, Features Tagged With: evidence-based medicine, guidelines, SinusitisIssue: July 2012

You Might Also Like:

  • Antibiotics for Sinusitis: To Use or Not to Use?
  • Evidence-Based Medicine Comes to Otolaryngology
  • Hoarseness Guidelines Continue to Draw Scrutiny: Panel members question evidence-based criteria
  • A New Direction for Sleep: New OSA guidelines fuel another evidence-based medicine debate

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.