A push to get US doctors to use the antibiotic amoxicillin in children with acute sinus inflammation appears to be paying off, a report published today in Pediatrics indicates. That's the good news. The bad news is that inappropriate prescribing of other, more powerful antibiotics remains "common and unnecessary" in kids with sinus woes, the authors say.
Acute sinusitis is very common, accounting for more than 3 million doctor visits annually. Antibiotics are frequently prescribed for this condition. Beginning in 2001, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) emphasised amoxicillin as the preferred antibiotic for most children with sinusitis.
The new report finds that these efforts have been successful in encouraging use of amoxicillin, instead of other more "broad-spectrum" antibiotics.
"This is important," Dr. Adam L. Hersh, an author on the report, told Reuters Health, "because amoxicillin is effective while at the same time, inexpensive and narrow-spectrum. Using broad spectrum antibiotics when narrow-spectrum antibiotics are appropriate may promote drug resistance and increases costs," Hersh explained.
Acute sinusitis often begins when a cold, which is caused by a virus, leads to inflammation in the lining of the sinuses. Colds can't be treated with antibiotics - but sometimes the inflammation leads to a bacterial infection. The bacteria Streptococcus pneumonia is a common cause of acute sinusitis and also of ear infections - what doctors call "otitis media." The two are considered similar diseases.
In 2000, a "pneumococcal" vaccine against otitis media was introduced, which was followed by a substantial decrease in the number of cases. And in 2004, the AAP recommended that amoxicillin be the "first-line therapy" for these ear infections (meaning that patients with otitis media should take amoxicillin before trying any other antibiotic). The vaccine, and the 2004 recommendation, led to increased use of amoxicillin for ear infections.