Dr. Choi - Chronic Sinus problem

Can you explain a little more clearly about the statement you made about sicker people with positive CRP benefiting from the Britain study?  I thought the study meant that having a sinus infection it would be better to go the saline and steroid route then taking all those antibotics.  Can you clear this up for me?  Thanks so much.

[Enoch Choi, MD]

Yes, for acute sinusitis (early, recent, short duration of symptoms) rather than chronic sinusitis (longer than 3 weeks of infectious symptoms), the JAMA study showed that these acute sinusitis were not benefited by antibiotics nor steroid nasal sprays.

That is to say, that this study refuted the Cochrane meta-analysis suggesting a benefit of using antibiotics with acute sinusitis.

The accompanying JAMA editorial pointed to a different study that showed that sicker patients with a positive CRP (c reactive protein) test could benefit from antibiotics.

The previous statement i made was to another forum user who described chronic sinusitis.  Antibiotics are helpful for chronic sinusitis, diagnosed by CT scan and/or percutaneous sampling of fluid.  We don't put a needle in sinuses to diagnose this in urgent care, so we treat by symptoms.