[NPInfo] Re: [ACC-Circle] Antibiotics and sinusitis again

[David Mittman]

One of the things in "our" defense was that there usually was a  
marked lessening of the headache and the patient started feeling much  
better almost immediately. That was evidence, but I guess not  
actually scientifically an evidence based study.
I DO know long acting decongestants work and would definitely use  
them!!!
Until the next study comes out!
Dave
On Mar 14, 2008, at 12:03 PM, Charlene M Morris wrote:

> WELCOME TO THE ACC-CIRCLE DISCUSSION LIST!
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>
> *********************************************************
> In our pharmacocentric society, this article sure makes sense to me
> ancedotally if not in actuality Pts WANT antibiotics, but it was an  
> older
> rural woman who taught me yesterday-- saline douching or wash  
> systems, such
> as sinurinse or Neti  pots of the sinuses works better at both  
> treatment and
> probably prevents recurrences without horrible side effects. Erudite
> references upon request.
>
> Antibiotics are way overused and we, unfortunately are part of that  
> problem.
>
> C M Morris
>
>
> On 3/14/08, David Mittman <dmittman at comcast.net> wrote:
>>
>> WELCOME TO THE ACC-CIRCLE DISCUSSION LIST!
>> Strength in Unity: Join the ACC today: http://www.amcollege.org
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>> Forgot to paste!
>>
>> Sinus bug antibiotics 'no good'
>> Doctors should cut down on antibiotic prescriptions for a common
>> infection because the drugs do not work, researchers say.
>> Around 90% of people with sinusitis in the UK are prescribed
>> antibiotics.
>> But an analysis of nine trials published in The Lancet shows the
>> drugs make no difference even if the patient has been ill for more
>> than seven days.
>> Sinusitis is very common - often occurring after colds or flu - with
>> 1-5% of adults diagnosed every year.
>> The infection of the sinuses - small air pockets inside the
>> cheekbones and forehead - causes a high temperature, pain and
>> tenderness in the face and forehead, and a blocked or runny nose.
>>
>>
>> Antibiotics really don't look as if they work
>> Dr Ian Williamson
>> Several guidelines advise doctors to prescribe antibiotics only when
>> the patient has been ill for seven to 10 days.
>>
>> It has been thought that this length of illness may indicate a
>> bacterial rather than viral infection which would be susceptible to
>> antibiotics.
>>
>> Not justified
>>
>> The latest research, which looked at how long 2,600 patients were ill
>> before they received treatment, found time of illness is not a good
>> indicator of whether antibiotics will be effective.
>>
>> Because of side-effects, costs, and the risk of resistance,
>> antibiotics are not justified even if patients have been ill for
>> longer than a week, the researchers concluded.
>>
>> The figures showed 15 patients would need to be treated before one
>> would be cured with antibiotics.
>>
>> Study leader, Dr Jim Young, from the Basel Institute for Clinical
>> Epidemiology in Switzerland, said: "If a patient comes to the GP and
>> says they have had the complaint for seven to 10 days that's not a
>> good enough reason for giving them the antibiotic."
>>
>> He added it would be reasonable for GPs to advise patients to come
>> back if symptoms got worse or went on for another week.
>>
>> The National Institute for Clinical and health Excellence (NICE)
>> published draft guidance this week advising GPs not to prescribe
>> antibiotics or issue delayed prescriptions which patients can use if
>> they do not get better.
>>
>> Co-author, Dr Ian Williamson, a GP in Southampton and researcher at
>> Southampton University, said sinusitis was a horrible condition and
>> people expected to get antibiotics from their GP to help them.
>>
>> "Antibiotics really don't look as if they work.
>>
>> "We have found that antibiotics aren't effective for sore throats and
>> ear infections but sinusitis, which is similar, is the one that
>> people are slightly more die hard about."
>>
>> Professor Steve Field, chair of the Royal College of GPs, said
>> doctors had been working hard to reduce antibiotic use for sinusitis
>> in recent years but there was probably still too many prescribed.
>>
>> "This gives reassurance to GPs that even if patients have specific
>> symptoms, it's unlikely antibiotics are going to make a dramatic
>> difference."
>>
>> He those suffering from the infection to relieve symptoms with steam,
>> paracetamol and rest.
>>
>> "You don't need to see the GP unless you've been ill for a week."
>>
>>
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