Antibiotic Resistance and Sinusitis

National polls indicate that 70 to 80% of physician visits for sinus infections resulted in a prescription for antibiotics. Because of the overuse and misuse of antibiotics to treat common conditions such as sinusitis, resistance to bacterial causes of upper respiratory infections (URI) has risen to 40% to 50% in the past two decades. Antibiotics are effective treatment for bacterial infections, but are useless as a defense against viral infections. Because testing to determine whether sinusitis is virally based or bacterially based can take an extended period of time, physicians have a tendency to prescribe an antibiotic for the problem without knowledge of whether the antibiotic will be an effective course of treatment or not.

According to the Centers for Disease Control (CDC), antibiotic resistance has been called one of the world’s most pressing public health problems, causing a significant problem in the treatment of diseases and infections that at one time were easily treatable with antibiotics. Antibiotics that now no longer work due to resistance result in longer-lasting illnesses, an increase in physician’s visits, extended hospital stays, and the need for more expensive and stronger medications.

Current statistics indicate that approximately 70% of the bacteria that cause infections are resistant to at least one of the drugs that are commonly utilized for treatment. Some bacterial organisms, such as the multi-drug resistant tuberculosis strain, are resistant to all federally approved antibiotics and can only be treated with experimental intraveneous medications. It has been documented that there is an alarming rate in the increase of resistant bacteria that cause community acquired infections, particularly in staphylococci pneumococci, which are prevalent causes of disease. Recent literature indicates that 25% of bacterial pneumonia cases have been shown to be resistant to penicillin and an additional 25% of cases were resistant to more than one antibiotic.

Bacterial resistance has resulted in expedited research and development in the search for new antibiotics in order to maintain a base of effective drugs at all times. While the evolution of drug-resistant strains of bacteria is inevitable, the irresponsible manner in which antibiotics are prescribed and administered has greatly increased the problem.

New guidelines issued by the Sinus and Allergy Health Partnership, with representation from the CDC, has been constructed to address the alarming rise in bacterial resistance to antibiotics. The guidelines were developed to assist health care professionals to diagnose acute bacterial rhinosinusitis (ABRS) more accurately, in order to reduce the use of antibiotics for non-bacterial infections and to recommend the use of the most effective antibiotics when ABRS is likely.

Although it is understandable that patients suffering from the symptoms of sinusitis want the immediate relief from an antibiotic, physicians must counsel patients to treat colds with medicines that will alleviate the symptoms of congestion and cough. Only when the symptoms of chronic sinusitis persist for an extended duration of time should antibiotics be prescribed for any patient.