THE END OF ANTIBIOTIC-TREATMENT IN ADULTS WITH ACUTE SINUSITIS-LIKE COMPLAINTS IN GENERAL-PRACTICE - A PLACEBO-CONTROLLED DOUBLE-BLIND RANDOMIZED DOXYCYCLINE TRIAL

Background. Acute sinusitis-like complaints are very common and are us ually treated with antibiotics in spite of the lack of evidence for th e effectiveness of antibiotic therapy and the increasing number of res istant strains. Aim. To assess the effectiveness of-doxycycline in adu lts with acute sinusitis-like complaints in general practice. Method T he effects of doxycycline in a placebo-controlled, double-blind, rando mized trial were assessed in adults consulting their general practitio ner (GP) with complaints after a common cold or influenza, pain in the head when bending forward purulent nasal discharge, predominantly uni lateral maxillary pain, toothache, or pain when chewing. Primary outco me events were the resolution of facial pain and the resumption of dai ly activities. Treatment differences were assessed by means of Kaplan- Meier curves and hazard ratios. The follow-up period was 42 days. Resu lts. No significant difference was found in time to recover between th e doxycycline-treated group and the placebo-treated group. However, th e adjusted hazard ratio for the group receiving doxycycline was 1.17 ( 95% CI = 0.87-1.57) for the resolution of pain and 1.31 (95% CI = 0.96 -1.78) for the resumption of daily activities. After 10 days, 85% of a ll patients reported improvement and 60% were completely cured. Side e ffects were reported by 17%;, of the doxycycline-treated group, with t wo patients withdrawing because of side effects. Conclusions. Data fro m this study indicate that doxycycline does not add to the effectivene ss of decongestive nose drops and steam inhalation in treating acute s inusitis-like complaints in general practice adults.