Antibiotics useless for most sinus infections

Nearly all people who have sinus infections don’t need antibiotics, according to new guidelines for doctors. 

Sinus infections are the fifth leading reason why doctors prescribe antibiotics. But 90 to 99 per cent of cases are caused by viruses that antibiotics won't help.

"There is no simple test that will easily and quickly determine whether a sinus infection is viral or bacterial, so many physicians prescribe antibiotics 'just in case,'" said Dr. Anthony Chow, chair of the guidelines panel and professor emeritus of infectious diseases at the University of British Columbia, in a release.

"If the infection turns out to be viral — as most are — the antibiotics won't help and in fact can cause harm by increasing antibiotic resistance, exposing patients to drug side effects unnecessarily and adding cost."

The guidelines were released Wednesday by the Infectious Diseases Society of America. They're the first guidelines the group has written on the topic to advise doctors.

The recommendations include:

• Distinguishing sinus infections that are likely caused by bacteria, based on the length, severity and combination of symptoms.
• Prescribing shorter antibiotic treatments for bacterial infections (five to seven days, down from 10 days to two weeks.)
• Avoiding decongestants and antihistamines that make sinus symptoms worse. Nasal steroids may help ease symptoms in people who have sinus infections and a history of allergies.
• Sterile saline irrigation may help some symptoms but children may be less likely to tolerate the discomfort of the treatment.

The guidelines are voluntary for physicians. They will be published in the April 15 issue of the journal Clinical Infectious Diseases.