A recent article in the Wall Street Journal revealed new findings by the American Academy of Otolaryngology, Head and Neck Surgery Foundation. They offered alternatives to using antibiotics to treat sinusitis. The foundation recommended “watchful waiting” before patients resort to antibiotics. The latest guidelines, published last week in the foundation’s journal, strengthen that recommendation, said Richard Rosenfeld, who chaired the group that devised the recommendations. In cases of acute sinusitis (symptoms lasting more than 10 days), the foundation recommends waiting 17 days to see if the symptoms go away on their own before taking antibiotics. Dr. Lane Krevit comments on this.
NYOG’s Dr. Lane Krevitt, agrees with the foundation’s findings.
“Observation is an excellent first line option in a non-immunocomprised patient. Depending on the clinical course there may very well be a role for antibiotics. Overprescribing antibiotics in the setting of viral infections is a setup for resistance.
Your ENT doctor plays an important role with the ability to take a culture for more clarity of the diagnosis. Supportive care such as decongestants, hypertonic saline irrigations and antihistamines are also very useful in setting of viral or bacterial infections.”
Here is a link to the full article.
Frequently Asked Questions
The American Academy of Otolaryngology recommends a "watchful waiting" period of 17 days for patients with acute sinusitis, which means waiting to see if symptoms resolve on their own before beginning antibiotic treatment. This guideline applies when symptoms have lasted more than 10 days.
Watchful waiting is recommended to reduce the overuse of antibiotics, which can lead to antibiotic resistance. Many sinus infections are viral and resolve without antibiotics, so observing symptoms before treatment helps avoid unnecessary medication and potential side effects.
An ENT doctor can accurately diagnose sinus infections by taking cultures to differentiate between viral and bacterial infections. They also guide the appropriate use of antibiotics and recommend supportive treatments such as decongestants, saline irrigations, and antihistamines based on the clinical condition.
Supportive care options for sinus infections include using decongestants to relieve nasal congestion, hypertonic saline irrigations to clear sinus passages, and antihistamines to manage allergy-related symptoms. These methods help alleviate discomfort while the body fights off the infection naturally.
Overprescribing antibiotics can contribute to the development of antibiotic-resistant bacteria, making future infections harder to treat. Since many sinus infections are caused by viruses, unnecessary antibiotic use does not speed recovery and can cause unwanted side effects.
No, not all patients with sinus infections require immediate antibiotic treatment. In non-immunocompromised patients, observation is often the first step to see if symptoms resolve naturally. Antibiotics may be considered if symptoms persist or worsen after the watchful waiting period.