Antibiotics should not be used for majority of sinus infections, NICE says

NICE has advised healthcare professionals to tell their patients that a sinus infection will clear up without antibiotics and that there is little evidence they will relieve symptoms.

The final guidance, developed with Public Health England, makes recommendations for trading acute sinusitis. In most cases, people who have sinusitis will start to feel better within a few weeks. The infection is usually viral, which means antibiotics should not be routinely prescribed, NICE says.

Instead, healthcare professionals should advise their patients on how to manage their aches and pains with paracetamol. They should also tell them there is no evidence oral decongestants or steam inhalation will make any difference, and inform them that they should seek further medical advice if their symptoms get worse or persist.

Inappropriate use of antibiotics is known to fuel resistance. Despite this, data has shown antibiotics are given to 91 per cent of people who visit their GP with symptoms of sinusitis.

Tessa Lewis, GP and chair of the managing common infections guidance committee, said: “We know that most people with sinus infections will recover in a couple of weeks without needing any antibiotics, but that doesn’t mean we should be sending them home without any information or advice.

“Health professionals can help their patients cope with this infection and the sometimes unpleasant symptoms it can cause. They should tell them that they’ll probably be feeling this way for a while, and that unless they are very unwell, the best thing to do is to take paracetamol and ‘take it easy’.”

Gillian Leng, deputy chief executive at NICE, said: “Antibiotic resistance is one of the greatest dangers to our health, which is why we must all work together to fight it.

“Our new guidance will help healthcare professionals to use antibiotics efficiently and only when they are really needed. This will help to protect these vital medicines and ensure that no one experiences side-effects from a treatment they do not need.”

Susan Hopkins, lead healthcare epidemiologist, AMR Programme, Public Health England, said: “PHE welcomes this new guidance and in particular the advice to manage the symptoms of pain or fever with paracetamol or ibuprofen instead of antibiotics; and highlighting the use of steroid inhalers in those over 12 who have symptoms longer than 10 days.

“Using antibiotics when they are not needed means that they are less likely to treat future infections which may have become resistant, potentially putting you and your loved ones at risk of longer and more serious infection.”