Trends in antibiotic treatment of acute sinusitis in the last decade - evidence based study

Abstract

Background: antibiotics are basic in treatment of acute bacterial sinus infection. Aim: which antibiotic classes are the most common used in clinical trials in treating acute bacterial sinusitis, according to EPOS 2007. guidelines. Data sources: relevant English-language articles identified in the PubMed Central and MEDLINE databases. Study selection: articles about antibiotic treatment of acute sinusitis in adults (19+years), all clinical trials, meta-analysis, practice guidelines and randomized controlled trials published in the last ten years. There were 91 articles, and 53 of them evaluated.Data extraction: articles about complications, no-bacterial and chronic sinusitis, case-reports, surgical treatments.Results: There are totally 15.456 patients in 53 clinical trials. Antibiotic-classes in evaluated trials: penicillin-gruop (49.06%), quinolons (35.86%), macrolids and ketolids (32.07%), cephalosporins (15.09%), carbapenems (3.77%). In relation to total number of treated patients, the most common antibiotics in observed period are from penicillin group (45%). Other antibiotics: quinolons 21.07%, telithoromycin 10.51%, cephalosporins 9.95%, macrolids 9.2%, and carbapenems in 4.24% treated patients. Short-course of antibiotic treatment (less than 7 days) confirmed as safe and effective in 80.7% trials.Conclusion: Although is the amoxicillin and amoxicillin/clavulanate still the most common antibiotic in treatment of acute sinusitis, recent clinical trials are more based on second-line antibiotics, more in single-dose and in short-course treatment