Antibiotics Have Limited Benefits for Children with Sinus Infections: Study

Researchers warn that trying to diagnose children with acute sinusitis by mucus discharge color is ineffective and often leads to unnecessary antibiotics

Testing children with acute sinusitis symptoms may dramatically reduce unnecessary antibiotic use and the rise of deadly, drug resistant illnesses, according to the findings of a new study.

Researchers report that only about a quarter of children prescribed antibiotics for severe sinusitis actually receive any benefit from the drugs, indicating that not all childhood sinus infections warrant antibiotic treatment. The findings were published on July 25 in Journal of the American Medical Association (JAMA).

Sinusitis, or a sinus infection, is a common childhood condition caused by inflamed nasal passages which can cause facial pain and nasal congestion. While sinus infections are often caused by various bacterial strains, the same symptoms can also be caused by viral infections which don’t respond to antibiotics.

The study comes as a growing number of health experts are calling for more widepspread bacterial testing of children with sinus illnesses, as part of an effort to reduce the overprescribing of antibiotics to children, which may be fueling the rise of antibiotic resistant infections. Such testing could also prevent overbilling of patients due to inappropriate antibiotic use.

Not All Child Sinus Infections Benefit From Antibiotics

In this latest study, researchers from the University of Pittsburgh School of Medicine examined clinical trial data on 510 children ages 2-11 with acute sinusitis symptoms. All children were tested for five categories of bacterial strains linked to sinusitis infections.

For ten days, 254 of the children received oral amoxicillin, a common antibiotic used for sinusitis treatment, while the remaining 256 children received a placebo.

According to the findings, only 28% of the children treated with antibiotics experienced significant relief. All of those children had also tested negative for the same two strains of bacteria.

The researchers noted that attempting to determine whether an infection was bacterial or viral by looking at the color of the nasal discharge was ineffective and often led to misdiagnosis. Instead, they called for bacterial strain testing, which could also potentially prevent up to 53% of unnecessary patient antibiotic costs, and reduce the risk of creating dangerous antibiotic resistant bacteria.

“In children with acute sinusitis, antibiotic treatment had minimal benefit for those without nasopharyngeal bacterial pathogens on presentation, and its effects did not depend on the color of nasal discharge,” the researchers determined. “Testing for specific bacteria on presentation may represent a strategy to reduce antibiotic use in this condition.”