According to the recent study which involved 166 adult patients from 10 primary care offices inSt. Louis, it takes the same time to cure acute sinusitis with antibiotics as it takes without them. To compare the quality of life improvement a controlled trial was conducted by Jane M. Garbutt, MBChB, from the division of general medical sciences atWashingtonuniversity school of medicine inSt. Louis,Missouriin which some patients were given a 10 day course of amoxicillin while others were given a placebo. The patients were required to have rhinosinustitis symptoms for around 7 to 28 days which failed to show any signs of improvement or deterioration or which improved first and then deteriorated later.
This study where patients assigned to the treatment group received amoxicillin 1500mg/day in divided doses for a period of 10 days while those assigned to the control group were administered with placebo alone was a tedious affair. Till the time their physicians felt the treatments were contraindicated, the patients were given a 5 to 7 day supply of symptomatic treatments which involved a dose of acetaminophen 500 mg every 6 hours in case of pain or fever ; pseudo ephedrine-sustained action 120 mg every 12 hours as needed for nasal congestion; guaifenesin 100 mg/5 mL every 4 to 6 hours as needed for cough; guaifenesin 600 mg every 12 hours as needed to thin secretions; 0.65% saline spray and dextromethorphan hydro bromide 10 mg/5 mL. The chief outcome involved the estimation of the effect of treatment at day 3 on the disease-specific quality of life.
For the first few days, to calculate the severity and frequency of 16 sinus related symptoms, the improved Sinonasal Outcome Test-16 (SNOT-16) was used. Physical symptoms like cough, runny nose along with the quality of life factors like reduced productivity, trouble concentrating and difficulty in sleeping were studied by the SNOT-16. The test revealed that for both the control group as well as the treatment group, the mean change in SNOT-16 scores for quality of life was similar at day 3 and day 10 but differed at day 7 with the amoxicillin group showing more improvement.
It was suggested that since out of the three main bacteria responsible for sinus infections, Haemophilus influenzae and Moraxella catarrhalis can be resistant to penicillin and amoxicillin and as such were not affected by the antibiotics. Even Streptococcus pneumoniae can show the signs of resistance.