Antibiotics Are Useless In Treating Most Sinus Infections 377
An anonymous reader writes "While doctors routinely prescribe antibiotics to treat sinus infections, researchers on Tuesday revealed that amoxicillin, the most commonly prescribed medication for nasal cavity inflammation and sinuses, was just as effective as a dummy pill. Researchers from the Washington University School of Medicine in St. Louis, Missouri, found that there was no significant difference in symptoms between patients taking amoxicillin to those who took the placebo three days after starting the pills were administered."
Re:Lets make Antibiotics obsolete (Score:5, Interesting)
Unfortunately some people need them. My son hearing loss is ascribed to under treatment of sinus infections
Few doctors use an endoscope to examine and sample the nasal passages. So they prescribe blind. That is what's ineffective. When they can see and sample the pus diagnosis and choice of an antibiotic suitable for the specific pathogen is reliable.
Pity the paper didn't point out the effective course of treatment, focusing solely on the known (but common) ineffective approach.
my favorite sinus remedy: simple, cheap (Score:5, Interesting)
Doctors have a tendency to recommend things that only they can recommend: prescription drugs, surgery, etc. They figure if you could do it yourself you'd have already done it.
But there's an ancient treatment for sinus problems that works really well: nasal irrigation [wikipedia.org]. Basically, you add 1/2 tsp salt to a cup of water, and flush that through your nasal cavity.
Wall Street's media was overjoyed when someone with parasites in their water supply recently died after they used their neti pot. So boil your water first if that's a problem where you live, mkay? (This is covered on the link above...)
Re:What does this sentence mean? (Score:2, Interesting)
Stupid and irresponsible people make the world difficult to live in. Please stop with your irrational behavior.
Re:my favorite sinus remedy: simple, cheap (Score:4, Interesting)
This is how I beat well over half of the sinus infections I get - nasal irrigation works great.
However, sometimes the infection is stubborn and it resists 1-2 weeks of irrigation, staying in a steady state of no improvement. At that point I'll usually give in and start antibiotics, and with one exception (Normally my infections are triggered by normal colds initially, or allergies, in this case one of my peak allergy periods occurred two weeks AFTER the initial infection trigger, which was sewage-laden dust from the September 2011 Susquehanna flooding), they have always cleared up the infection in only a day or so.
I think the problem is that in the article given, the doctors in question are probably starting the antibiotics too early - if it's the first few days of "infection" it's very difficult to separate viral causes (just a cold), allergic causes, and actual bacterial causes. Now if you're at nearly 2 weeks of routine nasal irrigation and you have frequent bright yellow discharge restart 2-3 hours after you irrigate - at that point it's much more likely to be bacterial.
Mayo clinic: most are viral (Score:5, Interesting)
quacks (Score:5, Interesting)
I inherited bad sinuses from my mother who occasionally gets wicked sinus infections and has to go on hardcore antibiotics, the kind that WIPE your digestive tract and turn your poo white.
Fortunately for me genetics diluted the problem and I don't get one more than once a year usually. I've tried to tough it out, load up on decongestants and expectorants (due to drainage) etc and all that happens is it gets my throat torn up like hamburger from the infected runoff combined with coughing. Lucky me, I'm going through my yearly round of that right now actually. I started myself on decongestants immediately and have been pounding down pepsi almost nonstop to try to keep my sinuses and throat clear, but it still looks like the throat version of red-eye in there. I might actually beat it without antibiotics for the first time this time since I've jumped on it so aggressively.
In the past it's usually been the same story. Try to use over-the-counter meds for a week, finally it is getting so bad that the yellow mucus overnight has my throat destroyed by morning. (which will improve somewhat during the day, but not enough, it's a losing battle day to night) Enough of those and I can't stop coughing and I sprint into the local "convenient care" before work and a random doc looks at me and prescribes a decongestant and expectorant (that cost 2x the OTC usually) saying he doesn't want to give me antibiotics YET. Thanks.
So I'm back in the office 3-4 day later, almost unable to talk, haven't slept in days, throat killing me, and throat is totally red with green mucus streaking down in the back. "Ooooh! you have a bad sinus infection now! Here's some antibiotics!" Thanks. Now why couldn't we have just done this three days ago instead of putting me through two days of hell?
So the last two times I went in I relayed the above story and they conceded maybe antibiotics before it gets REALLY bad is a good plan for me. And I was sooo thankful, instead of it taking several more days of winding down misery, another two weeks in all, one round of refills to clear up, it was much better the very next day and cleared up in 5 days, both times.
Whoever says antibiotics don't help sinus infections is a quack. I seriously wonder what would happen to people like me if there were no antibiotics, could it get bad enough to hospitalize or kill me?
Re:my favorite sinus remedy: simple, cheap (Score:1, Interesting)
Neti pots are great but are frequently used improperly.
If you have allergies, use cool water, not warm. Never use salt. Cool water opens the sinus and helps with drainage. Drainage issues are the number one cause of infection.
If you have an infection, this is the only time you'll use salt. I'd recommend starting with 1/4 tsp and work up to 1/2 tsp, no more, if you're not seeing results after a day. Remember, your sinus is already inflamed. Salt is an irritant to your sinus. Its possible that the use of salt can prevent proper drainage by causing additional irritation and inflimation.
Distilled, filtered, and/or boiled water all work well for a neti pots. Tap water in every place should be considered suspect. There is no such thing as 100% safe water out of a tap. While rare, bugs do make it past treatment plants in even the best of facilities. As your nasal passage is especially good at passing bugs in either direction, care should be taken. Now then, I'm not saying everyone needs to boil their water but understand anyone and everyone who doesn't do so with tap water is taking a risk, no matter how small. The deaths in LA while not flukes are rare. Just the same, understand its not impossible to happen in your neck of the woods.
BTW, for those of you with something like a Brita filter decanter, the difference between cheap vodka and expensive vodka is literally one or two passes through your filter. This is also true for some other types of booze. Enjoy!
Eat shit, not yogurt (Score:5, Interesting)
Your intestine has about a kilogram of symbiotic bacteria, with dozens of major species and hundreds of minor species. When you take antibiotics, you wipe out some or most of those species.
The bacteria in yogurt (usually a single species) are completely different. You can't repopulate the normal bacteria of your intestine with yogurt.
Nobody knows exactly how bacteria repopulate the bowel, but one thing you could try is a fecal transplant -- in other words, eat shit. This is not a standard medical procedure, but it's under serious investigation.
One of the problems with destroying the normal gut flora with antibiotics is that the gut is a major immunological organ. The immune system (all those white blood cells) has to decide whether a bacterial species is a normal symbiote or a pathogen, which is difficult and inaccurate. If you wipe out the normal flora and start again, your immune system might make mistakes.
Nobody knows what causes autoimmune diseases like multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosis, Crohn's, inflammatory bowel disease, etc., but wiping out the normal gut flora with antibiotics is a plausible mechanism.
So using antibiotics when you don't need them, in addition to promoting antibiotic resistance, might give you one of those horrible autoimmune diseases.