A recent randomized, placebo-controlled trial of adults with uncomplicated, acute rhinosinusitis was conducted to determine the incremental effect of amoxicillin treatment over symptomatic treatments for adults with acute rhinosinusitis.2
Study subjects (n = 166) were recruited from 10 community practices in Missouri between November 1, 2006, and May 1, 2009, and were randomized to receive either amoxicillin (1500 mg/ day) or placebo administered in 3 doses per day for a 10-day course. Patients also received symptomatic treatments for pain, fever, cough, and nasal congestion to use as needed. The primary end point of the study was improvement in disease-specific quality of life after 3 to 4 days of treatment assessed with the Sinonasal Outcome Test- 16 (minimally important difference of 0.5 units on a 0-3 scale).
Results showed that the mean change in Sinonasal Outcome Test-16 scores was not significantly different between groups on day 3 (decrease of 0.59 in the amoxicillin group and 0.54 in the control group; mean difference = 0.03 [95% CI, -0.12 to 0.19]). Additionally, there was no significant difference between groups on day 10 (mean difference = 0.01 [95% CI, -0.13 to 0.15]), but the groups differed at day 7, favoring amoxicillin (mean difference = 0.19 [95% CI, 0.024-0.35]). There was no statistically significant difference in reported symptom improvement at day 3 (37% for amoxicillin group vs 34% for control group; P = .67) or at day 10 (78% vs 80%, respectively; P = .71), whereas at day 7 more participants treated with amoxicillin reported symptom improvement (74% vs 56%, respectively; P = .02).
The authors concluded that among patients with acute rhinosinusitis, a 10-day course of amoxicillin, compared with placebo, did not reduce symptoms at day 3 of treatment.
1. Berg WA, Zhang Z, Lehrer D, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 2012;307(13):1394-1404.
2. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes [published online ahead of print March 26, 2012]. N Engl J Med. 2012;366(17):1567-1576.
3. Wegwarth O, Schwartz LM, Woloshin S, Gaissmaier W, Gigerenzer G. Do physicians understand cancer screening statistics? a national survey of primary care physicians in the United States. Ann Intern Med. 2012;156(5):340-349.
4. Avery AJ, Rodgers S, Cantrill JA, et al. A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis [published online ahead of print February 21, 2012]. Lancet. 2012;379(9823):1310-1319.
In Seniors: Consider CMV Serostatus
When Recommending Flu Vaccine
Older people who have cytomegalovirus seem to have less robust responses to the trivalent influenza vaccine than those who do not have CMV.
News from the year's biggest meetings
Clinical features with downloadable PDFs