Antibiotics Are Useless In Treating Most Sinus Infections

An anonymous reader writes "While doctors routinely prescribe antibiotics to treat sinus infections, researchers on Tuesday revealed that amoxicillin, the most commonly prescribed medication for nasal cavity inflammation and sinuses, was just as effective as a dummy pill. Researchers from the Washington University School of Medicine in St. Louis, Missouri, found that there was no significant difference in symptoms between patients taking amoxicillin to those who took the placebo three days after starting the pills were administered."

Comments

What does this sentence mean?

[fredrated]

"there was no significant difference in symptoms between patients taking amoxicillin to those who took the placebo three days after starting the pills were administered."

Re:What does this sentence mean?

[troc]

Antibiotics are very quick - their major effect is in the first couple of days of a 10 day (2 week, whatever) course. The extra week or more of pills is to make absulutely sure that everything that can be killed off, is. This is to prevent (or at least restrict) the chance of any drug-resistant strains developing.

One of the major problems in countries like France (where drugs are handed out like sweets) and in the developing world (where people can't afford the whole course, or save some for "next time") is people not finishing up a full course of antibiotics because 3 days in, they feel well and can't see the need to swallow any more of the evil pills that have given them diarrhoea and other stomach problems (the main side effect of broad spectrum antibiotics....).

Re:What does this sentence mean?

[i.r.id10t]

Which is why you should eat active yogurt cultures when you are on antibiotics ...

Re:What does this sentence mean?

[j00r0m4nc3r]

Sounds like a great plan, for the three people on the planet with no other responsibilities.

Re:What does this sentence mean?

[frenchbedroom]

Your first solution (coming over to the clinic each day) could theoretically work, but it's highly inconvenient in practice. There are still very sparsely populated areas in France, where commuting every day to the clinic is just not realistic. Not to mention the work overload on the clinics and hospitals, where nurses have more important stuff to worry about than checking if non-bedridden, able-bodied adults take their pills.

Your second solution is waaaaaay too easy to cheat out of, and it's also bad for the environment as it encourages people to throw their medication in the trash or in the sewers... when they should take it to the chemist's for safe disposal.

Personally I always take the full course when I'm on antibiotics, and when I have a friend or relative telling me they're on antibiotics, I remind them to complete the treatment.

The one thing I don't like about medication in France is that you almost always have to buy more than you need, because it comes in boxes of X pills, where X is never a multiple of the amount you need. That's actually one of the reasons why France is a drug champion, it skews the statistics. As I understand it, when you go to the chemist's in many other countries, they still do their traditional job of weighing the amount of drugs you need. Here in France they just push boxes.

Re:What does this sentence mean?

[Americano]

Make them come over to the clinic for their daily dose.

And when they feel better three days in, instead of stopping the antibiotics at home, they'll just stop showing up at the clinic. Showing up at the clinic daily would, in fact, make it MORE difficult for people to do a full course. "I could've taken the antibiotics at home, but stopped because I felt fine," is ignorance that can be mostly eliminated with proper patient education by doctors and pharmacists - "It is VERY important that you take the entire round of antibiotics. Here's why, and you can read this alarming pamphlet with full color nasty photos of tuberculosis victims to underscore the point."

"I could've taken the antibiotics at the clinic but it's 30 minutes out of my way and a huge hassle and I felt fine," is a much bigger problem to work around.

And seriously - fining people for not finishing the course? Good luck creating a giant new invasive government infrastructure to monitor and collect the fines. And good luck penalizing the poor & uneducated who are predominantly the ones who don't finish the course - because "I felt fine, and the drugs are expensive, so why not save them for a time when I don't feel fine again?" or "because I felt fine, and I have no comprehension of how these things work or why it's important to take them, so why bother?" Do you really think that $500k/yr Senior VP at BofA is going to not bother taking his meds? Of course not. You think the kid who had to work 20 extra hours last week to afford the meds might? Sure.

Biofilms

[tmosley]

You can't effectively treat biofilms with antibiotics. And that is exactly what this type of infection is--a biofilm.

A better approach is the use of biofilm "release" enzymes that signal the cells within the biofilm to stop producing EPS and detach from whatever surface they are clinging to. Use of such enzymes alongside antibiotics in a medical setting is likely to work even better.

slashdot title also written by a moron

[rubycodez]

amoxicillin, because there are no other antibiotics on planet earth.

yeah focus on symptoms, because progression of infection is irrelevant. three days, because all antibiotics cure by monday morning if course started friday morning

Obvious...

[Covalent]

Most sinus infections are viral. Nothing to see here.

Over-extapolating

[wonderboss]

Big leap from "no significant difference in symptoms between patients taking amoxicillin to those who took the placebo"
to "Antibiotics Are Useless In Treating Most Sinus Infections". How many bugs are resistant to amoxicillin at this point?
How many of the patients had bacterial infections?

inaccurate summary

[cinnamon colbert]

abstract is here http://jama.ama-assn.org/content/307/7/685.abstract
story itself, paid for probably with tax dollars is paywalled
The abstract says that yes, at 3 days, amoxicillin and placebo similar, but there was a diff at day 6
Also, total number of patients studied is quite small - Typical Bull**** "MD" science - mds just don't know how to do science, and they constantly flood the literature with these worthless studies, so the net result is a negative, cause you have towaste brain power to not pay attention

However, what is of more interest is the hard to read format of the abstract, which is a deliberate format imposed by the medical journals; the use of statistics in parenthesis, eg quote, mean difference between groups of 0.03 [95% CI, 0.12 to 0.19]) and on day 10 (mean difference between groups of 0.01 [95% CI, 0.13 to 0.15]), but differed at day 7 favoring amoxicillin (mean difference between groups of 0.19 [95% CI, 0.024 to 0.35]).
makes the abstract almost impossible to read; this practice has been criticized, but the idiot mds of course don't listen.
Not only that, with the number of people in the study, if you know naything of the history of medical studies, to give CIs is just BS, crazy statistics for no reason other then to tget a publication or satisfy the wierdness of hte editors; everything that is wrong with academic medicine is in this abstract
sorry for rant

Nope

[geekoid]

THE AC submission was alarmist and wrong.

The research did not show the anitbiotics are useless.

It showed the Amoxicillin had no significant statistical difference at day three. BUT statistically significant results on day 7, no difference on day 10.

What this means is the people taking Amoxicillin got better sooner.

The person who wrote the headline and summary should be ashamed of themselves.

Re:Lets make Antibiotics obsolete

[BlueParrot]

What we have hear is an ignorant mother fucker who has lived in a world with antibiotics and has no clue what life was like before them.

Which is exactly what you will get if antibiotics are over prescribed. Just look at what happened in countries that don't have effective regulations for medicines, like India. They're starting to see cases of tuberculosis that are resistant to ALL antibiotics, making it untreatable. When untreated TB kills 50% of patients.

Antibiotics are very useful, but they absolutely need to be used responsibly to minimise the risk of resistant infections. I'd argue abuse of antibiotics is even more troublesome than recreational drugs, since with antibiotic resistant infections the illnesses can then spread to other people, or even the whole world, causing severe damage that no narcotic could ever match.

Re:Obvious...Complications...

[BoRegardless]

It is entirely possible for a virus to give tissue damage that then results in a bacterial infection or visa versa!

Hence, I can easily believe that a rhinovirus could easily prevent clearing up a sinus infection with bacteria.

Biofilms, as mentioned by others, may also be an important variable.

It is anything but simple "Yes or No."