British Rhinological Society audit of the role of antibiotics in complications of acute rhinosinusitis: a national prospective audit

Abstract

Acute rhinosinusitis (ARS) is one of the most common presenting conditions to Primary Care physicians. Over-prescription of antibiotics has led to wide debate and divided expert opinion regarding the resulting increasing bacterial resistance or the merits of prevention of more serious complications of ARS. A national prospective audit was undertaken in the UK to evaluate use of antibiotics for ARS in Primary Care. British Rhinological Society members were asked to contribute patients admitted with complications of ARS, between Feb 2008–Feb 2009 to a national prospective audit via an on-line survey. Seventy-eight patients were admitted with complications of ARS. The majority of patients were started on antibiotics (59%) prior to admission, with penicillin/amoxicillin being most frequently (64%) prescribed. Similar complication rates were seen in patients treated with and without prior antibiotics. Despite prior antibiotic treatment, complications of ARS seem to occur sporadically. Our study has shown that the complications which require surgical treatment are similar in both the prior antibiotic treated group and the no prior antibiotic group, suggesting limited benefit of oral antibiotics in the Primary Care setting. Early recognition with CT scanning and appropriate hospital management is essential to reduce any subsequent morbidity or mortality.