A recent study from the Mayo Clinic, published in the journal Antimicrobial Stewardship & Healthcare Epidemiology, has examined the prescribing of antibiotics for patients with acute sinusitis, revealing that many do not meet the established criteria for their use.

The findings, after examining 1,000 randomly selected visits, showed that only 67.6% of visits met the recommended criteria, even though 89.2% received antibiotics. This includes 80.2% of consultations where the guidelines were not met.

Consequences of an inappropriate prescription

Results indicate that almost half of prescriptions (49.2%) aligned antibiotic selection and duration with clinical guidelines.

Factors such as cough and symptoms lasting seven to nine days were identified as predictors of inappropriate prescribing.

“Many factors have been identified in the literature that may contribute to inappropriate prescribing, including, but not limited to, diagnostic uncertainty, patient expectations, and pressure on healthcare professionals to meet patient demands,” the study authors wrote.

Control of antibiotic use

The authors of the study suggest that these findings may serve to establish reference parameters and optimize antibiotic prescription, contributing to better management of acute sinusitis in clinical practice.

Guidelines from the Infectious Diseases Society of America and the American Academy of Otolaryngology, referenced by the Center for Infectious Diseases Research and Policy (CIDRAP, University of Minnesota), recommend antibiotics when sinusitis symptoms persist for 10 days or more, when they are severe for three days or more, or when they worsen within 10 days after initial improvement.

Alternatives to antibiotics

There are several alternatives to antibiotics to treat most cases of acute sinusitis, especially when viral is suspected or symptoms are mild or moderate.

Main non-antibiotic options:

When to consider oral corticosteroids or other measures:

Evidence and practical guideline:

Practical tips for patients:

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