Predicting prognosis and effect of antibiotic treatment in rhinosinusitis

DE Sutter, An, Lemiengre, Marieke, Van Maele, Gorges, van Driel, Mieke, De Meyere, Marc, Christiaens, Thierry and De Maeseneer, Jan (2006). Predicting prognosis and effect of antibiotic treatment in rhinosinusitis. In: WONCA. WONCA Europe Regional Conference, Amsterdam Netherlands, (486-493). 01-04 June 2004. doi:10.1370/afm.600


Author DE Sutter, An
Lemiengre, Marieke
Van Maele, Gorges
van Driel, Mieke
De Meyere, Marc
Christiaens, Thierry
De Maeseneer, Jan
Title of paper Predicting prognosis and effect of antibiotic treatment in rhinosinusitis
Conference name WONCA Europe Regional Conference
Conference location Amsterdam Netherlands
Conference dates 01-04 June 2004
Proceedings title WONCA   Check publisher's open access policy
Journal name Annals of Family Medicine   Check publisher's open access policy
Place of Publication Leawood, TX United States
Publisher Annals of Family Medicine
Publication Year 2006
Sub-type Fully published paper
DOI 10.1370/afm.600
Open Access Status DOI
ISSN 1544-1709
1544-1717
Volume 4
Issue 6
Start page 486
End page 493
Total pages 8
Language eng
Formatted Abstract/Summary
PURPOSE In evaluating complaints suggestive of rhinosinusitis, family physicians
have to rely chiefl y on the fi ndings of a history, a physical examination, and plain
radiographs. Yet, evidence of the value of signs, symptoms, or radiographs in the
management of these patients is sparse. We aimed to determine whether clinical
signs and symptoms or radiographic fi ndings can predict the duration of the illness,
the effect of antibiotic treatment, or both.
METHODS We analyzed data from 300 patients with rhinosinusitis-like complaints
participating in a randomized controlled trial comparing amoxicillin with
placebo. We used Cox regression analysis to assess the association between the
presence at baseline of rhinosinusitis signs and symptoms or an abnormal radiograph and the subsequent course of the illness. We then tested for interactions to assess whether the presence of any of these fi ndings predicted a benefi cial effect
of antibiotic treatment.
RESULTS Two factors at baseline were independently associated with a prolonged
course of the illness: a general feeling of illness (hazard ratio = 0.77, 95% confi -
dence interval, 0.60-0.99) and reduced productivity (hazard ratio = 0.68, 95%
confi dence interval, 0.53-0.88). Neither typical sinusitis signs and symptoms nor
abnormal radiographs had any prognostic value. Prognosis remained unchanged
whether or not patients were treated with antibiotics, no matter what symptoms
patients had at baseline.
CONCLUSIONS In a large group of average patients with rhinosinusitis, neither
the presence of typical signs or symptoms nor an abnormal radiograph provided
information with regard to the prognosis or the effect of amoxicillin. The time to
recovery was longer in patients who felt ill at baseline or who did not feel able
to work, but the course of their illness was not infl uenced by antibiotic treatment.
Keyword Acute sinusitis
Family Practice
Antibiotics
Respiratory Tract Infections
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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