What are the benefits and harms of antibiotics for adults with acute rhinosinusitis?

A. CIAPPONI

Cochrane Clinical Answers

CROSSREF

Año: 2018

2050-4217

Compared with placebo/no treatment for adults (average age 31 to 43 years; 52% to 73% women) showing clinical signs and symptoms of acute rhinosinusitis, antibiotics increases the number of people cured by 7 to 14 days (644 vs 568 per 1000 people, number needed to treat for one additional cure [NNTB] 19; all values on average) and the number with resolution of purulent secretions within 8 to 10 days (744 vs 648 per 1000 people NNTB 10). In addition, fewer people experienced clinical failure (defined in 8 RCTs as an abnormal course of rhinosinusitis leading to commencement or extension of antibiotic therapy) with antibiotics (55 vs 109 per 1000 people). Trials show that most people had full resolution of pain between days four and seven, with no apparent benefit of antibiotics. However, more people experienced an adverse effect with antibiotics than with placebo/no treatment (257 vs 135 per 1000 people; number needed to treat for one additional adverse event 8); this may be due primarily to diarrhea, as this was the only specific adverse effect for which data were available. When reviewers rated the quality of the evidence, it was of high certainty.