Acute sinusitis is a bacterial infection of the sinus cavities; it is usually a complication of a cold in which the fluid present due to the cold becomes infected with bacteria. Antibiotics are usually used to treat sinus infections, but it is unclear whether antibiotics are really necessary. In this study, adults diagnosed with sinus infections were randomly given amoxicillin, amoxicillin plus nasal steroid, nasal steroid alone, or no active ingredient. There was no significant difference among any of these groups in symptom duration, suggesting that antibiotics (and nasal steroids) are effective in treating acute sinusitis.
One of the problems in treating sinusitis (and with this article) is how to distinguish bacterial sinusitis from viral respiratory infections. Antibiotics, of course, will not treat the viral respiratory infection at all. Another problem is that antibiotics clearly help a certain subset of patients; larger studies are necessary to determine which patients will benefit from antibiotics.
This study highlights two important facts: 1) antibiotics are not needed to treat viral respiratory illnesses (colds) in adults or children, though they are much overused in treating colds, and 2) antibiotics may not be needed in many cases of bacterial sinusitis. This parallels other research showing that antibiotics are not necessary or helpful in some other common infections such as ear infections. In these days of worsening bacterial resistance to antibiotics, we need to give antibiotics only to those who will benefit from them. It may be that many cases of sinusitis will resolve just as quickly without any antibiotic at all.
