Running head: SINUSITIS

Sinusitis
Salena Barnes
Georgia College and State University

Running head: SINUSITIS

2
Sinusitis

Sinusitis is inflammation of the tissues lining the sinuses. There are acute, subacute,
chronic, and recurrent sinusitis (National Institute of Health, 2014). Each diagnosis is dependent
upon the duration and frequency of the occurrence of the inflammation. Once the sinuses become
inflammed, they can become occluded or filled with fluid and microorganisms, resulting in an
infection. Symptoms of sinusitis are fever, facial pain, cough, congestion, nasal stuffiness,
fatigue, bad breath, and nasal drainage. Sinusitis affects 37 million Americans annually and 83%
receive a prescription for an antibiotic (Lari, Ghaffariyeh, Etesam, Mostafavi, & Alaghehbandan,
2010; National Institute of Health, 2014). Thus, practioners should be aware of best practices in
treating acute sinusitis.
This single, blind randomized control trial purposed to compare the efficacy of a 5-day
regimen of azithromycin (a macrolid antibiotic) with a 10-day regimen of co-amoxiclav
(combination of an aminopenicillin with a betalactamase inhibitor) for the treatment of acute
sinusitis. This study is different in that efficacy is determined in terms of symptom relief by the
participants. A total of 76 subjects with acute sinusitis were randomly assigned in two groups,
azithromycin (n=40) and co-amoxiclav (n=36). The first group was treated with 250 mg capsule
of azithromycin, 500 mg single dose on the first day and 250 mg single doses for the next for
days. The second group received a 625 mg coated tablet of co-amoxiclav, three times a day for
ten days. Each participant was visited by the physician four times: at baseline, by phone, at end
of treatment, and at the end of the study. At each visit, the decline or improvement in their
symptoms in response to treatment was recorded.
The duration of reduction in symptoms in the azithromycin group was significantly
shorter than the co-amoxiclav group (7.6 days versus 10.6, p=0.03) (Lari et al., 2010). Clinical

Running head: SINUSITIS

success rate at end of the study was 80% for azithromycin and 66.7% for co-amoxiclav, which
was significantly higher among azithromycin-treated subjects (p=0.025). In addition, clinical
success rates among females in both groups seemed to be higher than males (Lari et al., 2010).
It is important to note that patient symptom reduction as a measure for efficacy was
utilized in this study and can be extremely important in practice. Person that experience acute
sinusitis could find it more beneficial to be prescribed an antibiotic for a shorter duration, but
would also reduce the associated symptoms quickly and return them to their normal quality of
life and productivity sooner. Furthermore, better compliance is likely achieved with daily doses
versus multiple doses daily. This article is very relevant to practice, as antibiotic therapy will be
needed to treat most cases of sinusitis.

References

Lari, A. R., Ghaffariyeh, A., Etesam, N., Mostafavi, H., & Alaghehbandan, R. (2010). A
randomized controlled trial of 5-day regimen of azithromycin and a 10-day regimen of
co-amoxiclav for treatment of acute sinusitis. Iranian Journal of Clinical Infectious
Diseases, 5(3), 137-141.
National Institute of Health. (2014). Sinusitis. Retrieved from
http://www.nlm.nih.gov/medlineplus/sinusitis.html