New guidelines: millions will not get antibiotics for sinus infections this fall
(COLUMBUS, Ohio) September 2012 – In an effort to try and control increasingly drug-resistant bacteria, there are new guidelines in place this fall for the treatment of sinus infections. Each year it’s estimated some 45 million Americans suffer from sinus infections,¹ but after decades of over-prescribing antibiotics to treat them, doctors are being urged to take a new approach.
“We are creating a race of super-bacteria, which we will not be able to treat if something doesn’t change,” said Subinoy Das, MD, Director of the Sinus and Allergy Center at The Ohio State University Wexner Medical Center. “Instead of handing out prescriptions, these guidelines are encouraging primary care physicians, in most cases, to engage in watchful waiting,” said Das.
The guidelines, issued by the Infectious Diseases Society of America,² point out thatthe over-use of antibiotics is making bacteria more and more resistant to drugs used to control them. “Bacteria divide and share DNA every 20 minutes,” said Das. So, the more we bathe them in antibiotics, the more resistant they become. In fact, “there have been examples of certain strains of bacteria that now have genetic resistance to 17 different classes of antibiotics. That’s scary.”
The irony is, most sinus infections never really responded to antibiotics in the first place. Experts say for years, many patients were simply given the drugs to pacify them and to make them feel like their doctor was at least trying to relieve their pain. “About 80 to 90% of these infections resolve on their own,” said Das. “The truth is, antibiotics are very poor therapy for sinus infections, and doctors and their patients need to understand that.”
That’s something 42-year old Stephanie Santino learned the hard way. Santino says sinus infections have hounded her since she was a little girl and every trip to the doctor usually ended the same way. “I did a lot of unnecessary antibiotics and it just wasn’t helping,” she said.
After surgery to address her chronic infections, Santino says she and her family now use over-the-counter salt water rinses to battle sinus infections. “They are incredibly effective,” she said. “They go directly to the sight of the infection and really offer immediate relief.”
“For the most part, they are extremely safe,” added Das, “and not only do they help thin out any secretions you may have, but also prevent blockages that may be occurring in your sinus cavities.”
While most sinus infections will respond to over-the-counter therapies, Das cautions that there are times that medication is necessary, and signs you should know to watch for.
“Sinus infections that cause facial swelling, a severe fever or those that cause difficulty with your vision, can be signs of a severe infection,” he said. “If you experience any of those symptoms, don’t try to manage the sinus infection yourself, get to your doctor immediately.”
To better differentiate between run-of-the-mill sinus infections and those that pose a greater risk, Das and a team of scientists are hard at work. “We’re trying to develop a test strip that could be placed in your nose that would detect very trace quantities of proteins secreted from bacteria,” he said. “If we can know the source of your infection, we could treat you specifically with therapy that attacks your particular type of bacteria.”
Experts hope the test strip will be in use in doctor’s offices in the next few years.
¹Most Sinus Infections Don’t Require Antibiotics, Infectious Diseases Society of America, March 2012. Online: http://www.idsociety.org/2012_Rhinosinusitis_Guidelines/
²IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults, Infectious Diseases Society of America, March 2012. Online: http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/IDSA%20Clinical%20Practice%20Guideline%20for%20Acute%20Bacterial%20Rhinosinusitis%20in%20Children%20and%20Adults.pdf