Antibiotics Too Often Prescribed for Sinus Woes

Consider the case of the working physician called on to treat such a patient, said Dr. Neil L. Kao, vice chairman of the rhinitis/sinusitis committee of the American College of Allergy, Asthma and Immunology. He happens to be just such a working physician, in private practice in Greenville, S.C.

There are ways to determine whether a sinus infection is bacterial, Kao said. One is to do endoscopy, running a tube into the nose to obtain a sample of mucus from the sinus. Another is nasal cytology, examining a swab from the lining of the nose. A third is to take an X-ray.

"The problem with all of these is that they are expensive and time-consuming," Kao said. "The differences between symptoms caused by an allergy, bacterial infection, viral infection and a common cold are few. For us, even specialist doctors, when you see someone with acute nasal symptoms, it is hard to tell the cause. And the truth is that most of the people diagnosed with sinusitis go to primary care doctors."

Public awareness about antibiotic resistance is increasing, but most people suffering from cough, drip, lack of sleep and other sinus symptoms are likely to come in demanding an antibiotic, Kao said.

And so the physician often makes the practical choice of giving what the patient wants, with a chance of relief, over the more abstract issue of antibiotic resistance, he said.

More information

For more on sinus infections, head to the U.S. Centers for Disease Control and Prevention.