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THREE-DAY THERAPY FOR ACUTE SINUSITIS.

Acute maxillary sinusitis is usually treated with a 10- to 14-day course of antibiotics, along with analgesics and decongestants. This randomized trial tested whether a shorter antibiotic course is sufficient. Researchers compared 3 versus 10 days of treatment in 80 patients with sinus symptoms and radiographic evidence of maxillary sinusitis. Treatment included trimethoprim/ sulfamethoxazole (160/800 mg twice daily) and oxymetazoline nasal spray. After 14 days, about 76 percent of patients in both groups rated themselves as "cured or much improved." The two groups also had similar median numbers of days to clinical success. Comment: These data show no advantage for 10-day over 3-day courses of treatment for acute maxillary sinusitis. The authors suggest that afebrile patients who are not immunocompromised receive a 3-day course of antibiotics. Patients who do not respond should be reevaluated with x-rays, and those with confirmed sinusitis should receive a longer course of a broad-spectrum beta-lactamase-resistant antibiotic.

— TH Lee

Published in Journal Watch General Medicine April 11, 1995

Citation(s):

Williams JW, et al. Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis. JAMA 1995 Apr 5 273 1015-1021.

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