Antibiotics, Sinus Infections, Placebos, Oh My!

“Hey doc! I got an ear infection and my sinuses hurt. Give me some antibiotics,” said Joe public. Now, the sadly reality is that this isn’t too far from the truth. Dr. Fuhrman explains:
Many patients don't think a doctor is doing his job if he doesn't prescribe antibiotics or other medication. If he doesn't prescribe the medication they want, some patients actually will look for another doctor who will.
If I was a doctor, this little scenario would—quite frankly—piss me off, but, since big pharma has made most Americas pill-starved hypochondriacs, what can you except? More from Dr. Fuhrman:
Drug companies are a big part of this problem. They promote the use of their products through widespread advertising and the practice of giving free samples of the more potent, broad-spectrum antibiotics to doctors.


Most doctors perpetuate this problem because they give in to the pressure to prescribe antibiotics. They like to appear that they are offering an important and necessary service by writing prescriptions.
The scary part is, any self-respecting doctor will tell you antibiotics are useful, but, our overuse of antibiotics is making them less and less effective. Here Dr. Fuhrman talks about when antibiotics should be used:
Antibiotics are the appropriate treatment for severe bacterial infections. These infections include cellulitis, Lyme disease, pneumonia, joint infections, cat bites, meningitis, and bronchitis in a long-term smoker. Bronchitis in a non-smoker is just a bad cold. Almost every viral syndrome involves the bronchial tree and sinuses. The presence of yellow, brown, or green mucus does not indicate the need for an antibiotic.
So, with all this being said. What about sinus infections? Should physicians treat sinus infections with antibiotics? This blurb from Dr. Fuhrman will clear things up—no pun intended—take a look:
Sinusitis is not an appropriate diagnosis for the routine use of an antibiotic. Antibiotics should be reserved for the more serious sinus infections that show evidence of persistent symptoms lasting more than a week, such as continual fever and headache that accompanies facial pain and facial tenderness.
And let’s not forget, recent research already has determined that prescribing antibiotics is not always a good idea when treating sinus infections. The Associated Press reported:
The researchers say the findings are troubling because overuse of antibiotics is leading to more virulent and even drug-resistent bacteria. Their concerns echo those of doctors who've studied the effectiveness of antibiotics on ear infections.


"We don't want to be using up our antibiotics on these people," said Dr. Don Leopold, chair of the University of Nebraska Medical Center's Department of Otolaryngology who worked on the sinus study.

The study, which appears in the March issue of the Archives of Otolaryngology, looked at two national surveys of patient data from 1999 to 2002. They showed 14.28 million doctor visits were for diagnosed chronic rhinosinusitis and another 3.12 million for acute rhinosinusitis.
Let’s explore this more deeply. Remember this report from HealthDay News? Apparently many pneumonia patients receive antibiotics when they don’t really need them. Take a look:
The study, conducted in 2005, followed a group of 152 emergency room patients who met eligibility criteria for receiving antibiotics. Of this group, 65.1 percent received antibiotics within four hours of arriving at the hospital. The remaining 34.9 percent were identified as "outliers," and more than half (58.5 percent) of the outliers did not have a final diagnosis of pneumonia. And 43 percent of the outliers had an abnormal chest X-ray, compared with 95 percent of those who received antibiotics…


…"It was not possible in many of the cases to actually have given them antibiotics because a lot of them didn't actually have pneumonia or got a diagnosis later," said Dr. Jesse Pines, author of an accompany editorial in the journal, and an attending physician in the department of emergency medicine at the Hospital of the University of Pennsylvania. He supports the study findings.
Okay, but back to sinus infections. Anahad O’Connor of The New York Times conducts a brief and blunt mini-investigation of the claim that antibiotics will beat a sinus infection. Here’s a bit:
For years, doctors have prescribed what seemed like simple cures: a prescription for an antibiotic like amoxicillin or a steroid nasal spray. They may be the standard medications, but perhaps they are not as effective as once thought. Several studies have examined their effects and found that they are no better at shortening a sinus infection than no medication at all.


The latest study, published in December in The Journal of the American Medical Association, looked at 240 cases. The subjects were assigned to four groups for different treatments: a full amoxicillin course for a week along with 400 units of steroid spray for 10 days, just the spray, just the amoxicillin or just a placebo. The treatments were no better than placebo, a finding shown in studies of children. The reason is not entirely clear, but researchers suspect that antibiotics may not be very good at reaching the sinuses. Experts recommend other approaches like taking ibuprofen, inhaling steam or using salt water to flush the nasal cavity.
Makes sense to me, but in our quick-fix culture, I doubt it’ll catch on. Maybe if people were more in tune with the consequences of taking unnecessary antibiotics, they’d be more cautious. Dr. Fuhrman talks about it in Disease-Proof Your Child:
In every single person who takes an antibiotic, the drug kills a broad assortment of helpful bacteria that live in the digestive tract and aid digestion. It kills the “bad” bacteria, such as those that can complicate and infection, but it also kills these helpful “good” bacteria lining your digestive tract that have properties that protect from future illness.
This topic comes up a lot and people always seem concerned, but, like anything else, we probably won’t do anything about it until pandemonium is at our doorstep.
Trackbacks (0) Links to blogs that reference this article Trackback URL
Comments (4) Read through and enter the discussion with the form at the end
Jayson - January 9, 2008 10:23 AM

One thing I am happy to experience is the vanishing need for medications, pretty much a thing of the past. Seems you can get a "bug" but it doesnt, in my experience so far at least, keep me immobilized or unable to function on some level. With the kids its nice to go through a winter and episodes of the school having an outbreak of strep throat, and the kids not coming down with anything.

Knock on wood of course :-)

Jayson

Jocelyn - January 10, 2008 2:32 AM

Hey Gerald I have a new doctor and just before Christmas I had to go to visit her because of a sore ear. She said it was blocked and maybe infected. She said to hold my nose and gently blow and also gave me drops if the pain became to bad. When I told her about my diet she told me to keep up the good work and sent me home. I got the drops, but didn't use them.

It might be because I live in Australia and I see we ranked in the Top 3 for preventable treatments. However my doctor tries the easy things first. I only got the drops because it was Christmas Eve.

Joss

Gerry Pugliese - January 10, 2008 8:04 AM

Hey Jocelyn-

Great story. Kind of proves the point. Thanks!

Peace.
-Gerry

Vaclav Vasil - January 5, 2012 2:48 PM

Thanks for this post... It was very helpful and reassuring to me that I don't necessarily need the antibiotics if I get a sinus infection. I had a severe infection in 1999 and had a surgery on my sinuses and it got better. But occasionally it gets really bad, if I eat the wrong things like sugar and white flour, usually around Christmas time...like right now. I wonder if I should do water fast, or juice fast to speed up the healing process. Or if I should cut out certain things from my diet, even all together... The white flour and sugar are now blacklisted, none for me anymore! Any suggestions, Tom?

Post A Comment / Question Use this form to add a comment to this entry.







Remember personal info?