The media, in recent years, has publicized a medical concept that I have long held at the core of my practice: Most of us do not need antibiotics for sinus infections. The popular medicinal resource, WebMD featured a study that combined 9 separate trials featuring more than 2,500 people showing that antibiotics are neither effective nor needed, even if the cold lasts 10 or more days [WebMD]. Their numbers show that for every 15 antibiotic prescriptions for sinus infections, 14 result in no benefit.
Unfortunately, I think this was largely ignored by physicians and patients, as we continue to believe that the only relief for congestion is antibiotics.
As a physician, I’m at a loss. To my knowledge, there is no medical organization that recommends antibiotics in the first 7-10 days of symptoms [Source: AAFP]. Yet, every cold season patients show up in droves to get their prescriptions.
My clientele excluded, they are getting them, often with the option of a refill just to be sure. Is the cause simply that most docs know what the evidence shows, but don’t have the time to change the patient’s habits or fear they will upset them? The message can be delivered in 5 minutes! If we all just agree to simply follow the guidelines that good science has laid out, we could ignite true change. Americans spend nearly $6 billion annually on unnecessary cold and sinus infection prescription and over-the-counter medications, with only empty results for a receipt.
An upper respiratory infection generally starts with a sore throat and fever for a couple days, then significant nasal congestion and sinus pain for 5-7 days. As things break up, a congested cough usually develops (“Doc, its moved into my chest”) that may last an additional 7-10 days.
As a society, let’s leave the antibiotics for those with documented bacterial infections. Next time you get stuffy, let your body do what it is trained to do; fight invaders and strengthen itself.Do:
- Sinus flushing
- Drink plenty of water
- Avoid dairy products (promotes and thickens congestion)
- Take 2 cloves of garlic daily (chopped and swallowed or put in broth)
- Adults, take 2 teaspoons of honey at night for the cough
Consider getting checked out if symptoms (fever, sinus pain) are getting worse at 10-14 days or you are immune compromised, have chronic lung disease or have other concerns.
For more information, visit the CDC’s Get Smart page.