National Institute for Health and Clinical Excellence (NICE)
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Antibiotics should not be used to treat the majority of sinus infections, NICE says

NICE is advising healthcare professionals to tell their patients that a sinus infection will likely clear-up without antibiotics and that there is little evidence oral decongestants will help to relieve their symptoms.

Antibiotics should not be used to treat the majority of sinus infections, NICE says

The final guidance, developed with Public Health England, makes recommendations for treating acute sinusitis.

In most cases, people who have sinusitis will start to feel better within two-to-three weeks. The infection is usually viral, which means antibiotics should not be routinely prescribed, the guidance says.

Instead, NICE says healthcare professionals should advise their patients on how to manage their aches and pains with paracetamol.

They should also tell them that there is no evidence oral decongestants or steam inhalation will make any difference. And inform them that they should seek further medical advice if their symptoms get worse, or last for more than three weeks.

Dr Tessa Lewis, GP and chair of the managing common infections guidance committee, said: “We know that most people with sinus infections will recover in a couple of weeks without needing any antibiotics, but that doesn’t mean we should be sending them home without any information or advice.

“Health professionals can help their patients cope with this infection and the sometimes unpleasant symptoms it can cause. They should tell them that they’ll probably be feeling this way for a while, and that unless they are very unwell, the best thing to do is to take paracetamol and ‘take it easy’.”

Inappropriate use of antibiotics, such as taking them for viral conditions is known to fuel resistance. Despite this, data has shown antibiotics are given to 91% of people who visit their GP with symptoms of sinusitis.

Healthcare professionals should avoid prescribing antibiotics unless the symptoms are prolonged, says NICE. If the person has had symptoms for more than 10 days it might be appropriate to offer them a back-up prescription. And in circumstances where there are signs of a more serious illness, for example, double vision or a severe headache, the guidance says these people should be referred to hospital immediately.

Professor Gillian Leng, deputy chief executive at NICE said: “Antibiotic resistance is one of the greatest dangers to our health, which is why we must all work together to fight it.

“Our new guidance will help healthcare professionals to use antibiotics efficiently and only when they are really needed. This will help to protect these vital medicines and ensure that no one experiences side-effects from a treatment they do not need.”

Susan Hopkins, Lead Healthcare Epidemiologist, AMR Programme, Public Health England said: “PHE welcomes this new guidance and in particular the advice to manage the symptoms of pain or fever with paracetamol or ibuprofen instead of antibiotics; and highlighting the use of steroid inhalers in those over 12 who have symptoms longer than 10 days.

“Using antibiotics when they are not needed means that they are less likely to treat future infections which may have become resistant, potentially putting you and your loved ones at risk of longer and more serious infection.”


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