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Antibiotics are prescribed too often for sinusitis

Sinus infections are one of the most common reasons for an antibiotic prescription although bacteria cause only about one-third of sinus infections, which means most patients are inappropriately receiving antibiotics. To curb unnecessary antibiotic prescribing, the US Dr. Mark Ebell and his Danish colleague, Dr. Jens Hansen, developed a clinical decision rule for diagnosing acute rhinosinusitis and acute bacterial rhinosinusitis. CRP was part of the clinical decision rule. Dr. Ebell wanted to call attention to the fact that the CRP test is not available for most US primary care settings although it’s widely used elsewhere and it has been shown to decrease inappropriate antibiotic use. Ebell’s next plan is to perform a randomized clinical trial to test the effectiveness of the point score system, including the use of a CRP test, in clinical practice. “We need to give physicians better tools to support their decision-making, and that can include clinical decision rules and point of care tests like CRP,” Dr. Ebell said. “Using these kinds of tools, we can hopefully reduce unnecessary antibiotic use.”

The study, “Proposed Clinical Decision Rules to Diagnose Acute Rhinosinusitis Among Adults in Primary Care,” is available online:

Additional information: University of Georgia, 26 July 2017: