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Antibiotics and Nasal Steroids for Acute Sinusitis
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To the Editor: Rather than represent a lack of antimicrobial efficacy, the null results reported by Dr Williamson and colleagues1 in their trial of antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis more likely stem from inappropriate use of diagnostic criteria proposed by Berg and Carenfelt2 in a sample for which they were never intended.
Of the patients in the study by Berg and Carenfelt, 100% presented to an emergency department compared with 0% for Williamson et al (all were primary care); 25% had symptoms for 3 weeks to 3 months compared with a median of 7 days (maximum, 28 days) for Williamson et al; and 20% had used antibiotics in the past 2 weeks compared with 0% (none in the past month) for Williamson et al. The study by Berg and Carenfelt did not exclude patients with recurrent sinusitis, but potential participants with 2 or more . . . [Full Text of this Article]
Richard M. Rosenfeld, MD, MPH
richrosenfeld@msn.com
Department of Otolaryngology
SUNY Downstate
Brooklyn, New York
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