Sinusitis FAQ

CNN: Antibiotics ineffective for sinus infections in children

Question:

"CHICAGO, Illinois (AP) — Antibiotics have little or no effect against most acute sinus infections in children, despite guidelines that recommend their use when symptoms linger, a study found…. "The study, which involved 161 children who had up to four weeks of symptoms and were diagnosed with acute sinusitis, appears in the April issue of the journal Pediatrics. It was led by Dr. Jane Garbutt of the Washington University School of Medicine. "The youngsters, 8 years old on average, were given one of two common penicillin-type amoxicillin drugs or dummy pills for two weeks. By the 14th day, about 80 percent of the children in all three groups showed similar improvement…." http://www.cnn.com/2001/HEALTH/parenting/04/02/sinus.kids.ap/index.ht… — Steven D. Litvintchouk                   Email:  s…@mitre.org                 Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

Yes, and  in the Lancet study the placebo patients did about as well as the amoxacillin ones. The study on children you quote is discussed in The Sinus Cure book with instruction on doing Proetz irrigation for young children. Murray Grossan, M.D. http://www.ent-consult.com http://www.TinnitusRelief.net

Response:

As you are probably aware, plain amoxicillin is relatively useless for most acute or chronic sinus infections.  Without the addition of a beta lactamase enzyme inhibitor, these older penicillins are at best little better than using sugar pills.  I don’t see the value in conducting a study with drugs that are now over 20 yrs. old. (Amoxil FDA approved 1979).   Newer generation penicillins DO work against MOST sinus bacterial infections; but of course this isn’t mentioned in the article. Michael M. "Steven D. Litvintchouk" <s…@mitre.org> wrote in message news:3AC96F92.75D598B6@mitre.org… > "CHICAGO, Illinois (AP) — Antibiotics have little or no effect against > most acute sinus infections in children, despite guidelines that > recommend their use when symptoms linger, a study found…. > "The study, which involved 161 children who had up to four weeks of > symptoms and were diagnosed with acute sinusitis, appears in the April > issue of the journal Pediatrics. It was led by Dr. Jane Garbutt of the > Washington University School of Medicine. > "The youngsters, 8 years old on average, were given one of two common > penicillin-type amoxicillin drugs or dummy pills for two weeks. By the > 14th day, about 80 percent of the children in all three groups showed > similar improvement…."

http://www.cnn.com/2001/HEALTH/parenting/04/02/sinus.kids.ap/index.ht… – Hide quoted text — Show quoted text -> — > Steven D. Litvintchouk > Email:  s…@mitre.org > Disclaimer:  As far as I am aware, the opinions expressed > herein > are not those of my employer.

Response:

Michael Muloin wrote: > As you are probably aware, plain amoxicillin is relatively useless for most > acute or chronic sinus infections.  Without the addition of a beta lactamase > enzyme inhibitor, these older penicillins are at best little better than > using sugar pills.  I don’t see the value in conducting a study with drugs > that are now over 20 yrs. old. (Amoxil FDA approved 1979).  

The value of this study, is that for many family physicians, plain amoxicillin is STILL the first-line drug of choice for childhood sinusitis.  (My own ENT prescribes it for that purpose.)  So this study is basically showing that such therapy isn’t any more effective than placebo. Perhaps the proper conclusion to be drawn from the study is that amoxicillin should be withdrawn as first-line treatment for sinusitis. — Steven D. Litvintchouk                   Email:  s…@mitre.org                 Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

ENTconsult wrote: > Yes, and  in the Lancet study the placebo patients did about as well as the > amoxacillin ones. > The study on children you quote is discussed in The Sinus Cure book with > instruction on doing Proetz irrigation for young children.

I’ll bet that a larger proportion of childhood sinus infections are VIRAL than adult sinus infections (which are often BACTERIAL).  And the reason for that, may be that the chronic inflammation and swelling that predisposes stagnation of mucus in sinuses (a growth medium for BACTERIA) takes years to develop.  A child may be born with a deviated septum, but it’s only when he becomes an ADULT that enough inflammation has occurred for the ostia to become blocked. — Steven D. Litvintchouk                   Email:  s…@mitre.org                 Disclaimer:  As far as I am aware, the opinions expressed herein             are not those of my employer.

Response:

Filed under: Acute sinusitis

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