Antibiotics not needed for rhinosinusitis

Physicians now have more ammunition for not treating patients with acute rhinosinusitis with antibiotics, based on the results of a new study that shows amoxicillin is of no benefit in these patients. Researchers at Washington University in St. Louis randomized 166 adults with uncomplicated, acute rhinosinusitis to a 10-day course of amoxicillin 500 mg three times a day or matching placebo. The main outcome (change in the Sinonasal Outcome Test) was not significantly different between the two groups at day 3 or day 10. There was a slight improvement in the antibiotic group at day 7. The authors conclude that "treatment with amoxicillin for 10 days offers little clinical benefit for patients clinically diagnosed with uncomplicated acute rhinosinusitis." Patients with symptoms indicative of serious complications were excluded from the trial (JAMA 2012;307:685-692).