Acute Bacterial Rhinosinusitis

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About two-thirds of the patients with acute rhinosinusitis receiving placebos recovered without antibiotics. Antibiotics are superior to placebo in the treatment of rhinosinusitis. Amoxicillin/clavulanate is more effective than the cephalosporin class of antibiotics in the treatment of sinusitis only in the short-term follow up, with an absolute risk difference of about 3.5 percent.

There are only a few studies that specifically examined the effect of different treatment duration on outcome efficacy; they generally found no difference between shorter and longer duration of treatment. It is not possible to compare the rates of adverse events across different antibiotic classes. Severe adverse events in general are uncommon; they occurred in up to about 3.5 percent of patients in all classes of antibiotics.

As of September 2004, there have not been any published studies examining the effect of the pneumococcal vaccine on the treatment of acute sinusitis.
A minority of studies were placebo controlled. In addition, from a health care cost standpoint, there were very few comparative studies between newer antibiotics and older inexpensive ones (like amoxicillin and trimethoprim/sulfamethoxazole).

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