Antibiotics don't speed sinusitis recovery: study

April 4, 2001

,

I can honestly say that what was said in this post is all wrong where robert

is concerned. It could be right with other kids but not robert. one thing i

saw was treating a child with amoxicillan. only kids under the age of 3 are

treated with amoxcillan now. Augmentum and Erithamisus(sp) are front line

AB's for infection with kids over the age of 3.

x-rays do show infection in the sinus but not how bad the infection is. the

only way to see that is by ct scan. the sinus behind the eyes can't be seen

by regular x rays only by ct scan.

Like i said robert has shown to be unusual with his condistion so the dr

says. i wish robert was as easy to treat as that post said. It would

certainly get rid of some of my stress and give him a more normal life.

I am expecting him to have another bout with his sinus after today. we have

hurricane warnings/alerts and that with thunderstorms usually mess him up.

the humid air makes it hard for him to breath. he says the air feels so thick

that he can't breath. i can't wait for his surgery so he can breath better.

shelly

April 4, 2001

My son has had rotten sinuses since he was a lil kid and he is 15 now and I

know the only thing that clears him up whenever is to be put on strong

antibiotics....and nasal sprays....he gets asthma(can go from 100%lung

capacity to 20% in a an hour at times)if the stuff gets to his chest and then

possible pneumonia....so I try to keep him on his inhalers like he should. He

takes showers every morning and inhales water off his hands and then gets his

sinuses cleaned out...sounds gross I know but his dr said it was easy and

best way to clean them...fortuinately he has never had to have surgery on

them....Judy in AZ

April 4, 2001

Antibiotics don't speed sinusitis recovery: study

By Merritt McKinney

NEW YORK, Apr 02 (Reuters Health) - Most children with cough, runny nose and

other symptoms of sinus trouble are unlikely to benefit from antibiotics,

researchers report.

In a study of children diagnosed with acute sinusitis lasting at least 10

days, those given an inactive (placebo) pill were just as likely to get

better as children prescribed antibiotics. Symptoms improved within 7 days

in 81% of children in each group and within 10 days in 87% of all children.

" There was no benefit of antibiotics versus placebo for getting rid of

symptoms, " the study's first author, Dr. Jane M. Garbutt of Washington

University in St. Louis, Missouri, told Reuters Health in an interview.

The study included 188 patients aged 1 to 18 diagnosed with acute sinusitis.

Symptoms such as cough, runny nose and green nasal discharge had lasted 10

to 28 days. Researchers did not enroll patients with more severe sinusitis,

characterized by longer-lasting symptoms, facial pain and swelling and

fever.

Children were treated with a placebo or one of two types of antibiotics,

amoxicillin or amoxicillin-clavulanate.

The study also found that antibiotic therapy was no better than placebo for

preventing the relapse or recurrence of symptoms, or reducing absences from

school or day care. Side effects were similar in all three treatment groups,

although children taking amoxicillin were more likely to experience

abdominal pain, the researchers report in the April issue of the journal

Pediatrics.

" It's a difficult study to report...(since) it doesn't make life any

easier, " according to Garbutt. Antibiotics " are not the panacea they were

thought to be " for sinusitis, she continued.

Although some parents are concerned that a child will develop complications

if symptoms are left untreated, " that's highly unlikely, " Garbutt stated.

" If you just hang in there, the children will get better on their own, " she

said.

Garbutt acknowledged that diagnosing and treating sinusitis in children--and

adults--is difficult, since there is no good diagnostic test. Even though

x-rays are sometimes used to confirm a diagnosis of sinusitis, they are

unreliable, she said.

Most cases of sinusitis appear to be caused by viruses, against which

antibiotics are powerless, Garbutt explained. But she noted that the study

does not mean that antibiotics should never be used to treat sinusitis or

other acute respiratory illnesses, only that they should be used

" judiciously. " Some children may have bacterial infections that will respond

to antibiotics, so a doctor may prescribe antibiotics for some children with

symptoms that will not go away on their own, she said.

Since amoxicillin-clavulanate--known as a broad-spectrum antibiotic because

it targets a wide variety of bacteria--was no better than amoxicillin alone

at improving symptoms, amoxicillin appears to be a better choice if a doctor

decides to prescribe an antibiotic for sinusitis. Prescribing the more

targeted antibiotic may reduce the risk of developing antibiotic resistance

in a variety of bacteria, she noted.

While Garbutt said that there is little evidence that over-the-counter

medications such as decongestants provide much relief to sinusitis

sufferers, she said over-the-counter pain medications may help children feel

better.

The study was funded by the Hoechst n Roussel ACCORD Grants Program.

SOURCE: Pediatrics 2001;107:619-625.

April 5, 2001

Hey, ! There is no denying that 's sinus problems are in a class

such that he wouldn't have been included in this study. I really hope that

his surgery alleviates his discomfort permanently.

One important conclusion one can draw from this study is that the authors

believe that most sinusitis cases in children are very likely caused by

viruses, not bacteria, so antibiotic treatment would be absolutely

ineffective most of the time.

In this article they also point out that diagnosis is difficult. In

addition, it's not practical to order x-rays or costly CT scans for each

child who comes in with sinusitis symptoms. Again, as you said and as I

know, is a very special exception and not a typical case of childhood

sinusitis; they stated that in the study they excluded severe cases.

Right now in medicine there is a growing and important movement to reduce

the amount of unnecessary prescriptions for antibiotics physicians write.

Across the globe, but particularly in the US, we have overused antibiotics

to such an extent that we have come up against some strains of bacteria that

are very difficult to treat now.

Also, the study isn't saying that physicians should never prescribe

antibiotics for acute sinusitis, it is suggesting that, most of the time, it

is not going to help.

Augmentin is amoxicillin and potassium clavulanate. I'm not sure about the

other antibiotic you mentioned. I'm assuming it's some form of erythromycin.

----- Original Message -----

From: <12341234@...>

< >

Sent: Wednesday, April 04, 2001 12:09 PM

Subject: Re: [ ] Antibiotics don't speed sinusitis recovery: study

> ,

>

> I can honestly say that what was said in this post is all wrong where

robert

> is concerned. It could be right with other kids but not robert. one thing

i

> saw was treating a child with amoxicillan. only kids under the age of 3

are

> treated with amoxcillan now. Augmentum and Erithamisus(sp) are front line

> AB's for infection with kids over the age of 3.

>

> x-rays do show infection in the sinus but not how bad the infection is.

the

> only way to see that is by ct scan. the sinus behind the eyes can't be

seen

> by regular x rays only by ct scan.

>

> Like i said robert has shown to be unusual with his condistion so the dr

> says. i wish robert was as easy to treat as that post said. It would

> certainly get rid of some of my stress and give him a more normal life.

>

> I am expecting him to have another bout with his sinus after today. we

have

> hurricane warnings/alerts and that with thunderstorms usually mess him up.

> the humid air makes it hard for him to breath. he says the air feels so

thick

> that he can't breath. i can't wait for his surgery so he can breath

better.

>

> shelly

April 5, 2001

,

yes you are right robert is in a class all his own. lol. you are also right

that drs write a prescrition to quickly this days. I have seen parents have

fits because the dr didn't give their child or themselves an AB. I say if you

don't need it, don't take it.

I guess i missed the part about not counting the severe cases. It wouldn't

surprise me. Muscle relaxants do seem to cloud my brain a bit.

I live in an area that roberts dr says that he sees half the kids in the area

cause of all the pollution and pollen around here. He said that in a study

the goverment is doing Mobile, Alabama is one of the worst places to live if

you have sinus allergies or allergies in general and asthma.

yes you assumed right about the AB. can't take either of those, dr

says to much of a chance for him to have an allergic reaction since he is

allergic to penicillen. Both of those ABs upset my tummy and upset justin and

jareds tummy to, if i remember correctly its also affects jesse but not jake.

shelly

April 5, 2001

and all,

Just to let you know, the drs office called with the benifits for

surgery. Our insurance said no deductable and it covers 100% of the surgery

just have a co pay for the hospital that they will bill us for but my ex

husband will be coming up for the surgery and he will pay for that and they

said it shouldn't be more then $50.00. More good news. I also got a letter

from the dr stating about how serious roberts problem is so iam setting up a

new IEP meeting because i think his problem has affected his grades a bit.

Iam not gonna let them label like they did jesse and jake. has

to go to that school next year and they might as well realize now i am not

gonna take any more crap from this school district any more.

shelly

April 5, 2001

Hi, ...I would love to see the actual study...do you have it available

for me to read? I have known for a long time that antibiotics don't really

help sinusitis, but, only to stop the secondary infection of Bacterial

Meningitis...

Thanks!

AiMeE....Herbalist

Message: 4

Date: Wed, 4 Apr 2001 20:19:08 -0500

From: " Matsumura " <Matsumura_Clan@...>

Subject: Re: Antibiotics don't speed sinusitis recovery: study