Most Courses of Antibiotics for Sinusitis Are Too Long

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

When antibiotics are prescribed for acute bacterial sinusitis in adults, most courses exceed the duration recommended by national guidelines, according to a research letter in JAMA Internal Medicine. The Infectious Diseases Society of America (IDSA) recommends 5–7 days of treatment for sinusitis when antibiotics are indicated.

Researchers examined data on nearly 3.7 million office visits in 2016 during which antibiotics were prescribed for sinusitis. Overall, the median length of prescriptions was 10 days. In addition, 70% of prescriptions were for 10 days or longer, and after azithromycin was excluded, this proportion rose to 92%.

Of note, over 20% of prescriptions were for 5 days of azithromycin — despite IDSA recommending against its use due to concerns about resistance.