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Research: antibiotics unwarranted for runny noses

Media Release 24 July 2006

University of Auckland research finds antibiotics not warranted for runny noses

Visiting your doctor with a green runny nose should not be a signal to emerge with a handful of antibiotics. That's the conclusion from a study published this week in the British Medical Journal by two researchers from The University of Auckland.

"Most patients will get better without antibiotics, supporting the 'no antibiotic as first line advice,'" Dr. Bruce Arroll and Associate Professor Tim Kenealy reported in the July 22 electronic edition of the British Medical Journal.

While antibiotics probably are effective for some cases of acute purulent rhinitis, as runny noses with coloured discharge are technically referred to, "they can cause harm, usually in the form of gastrointestinal effects," the researchers from the Faculty of Medical and Health Sciences added.

Their research was based on an examination of data from seven carefully controlled trials, comparing results when antibiotics were or were not given (via a placebo component) to people presenting with severe head colds and runny noses. The study, partly funded by the Royal New Zealand College of General Practitioners, concluded that the great majority of patients did not actually benefit from antibiotic treatment.

Depending on which individual trial was studied, anywhere from six to 14 people had to be given antibiotics for any one of them to benefit. The side effects of antibiotic therapy in patients across the studies included vomiting, diarrhoea and abdominal pain. Such side effects occurred in only one of 78 patients in one study, but one in 12 patients in another study.

Rhinitis is typically defined as an inflammation of the nose, generally due to an allergy. If an infection is responsible, it almost always is caused by a virus, against which antibiotics are ineffective. On the other hand, sinus infections are usually caused by bacteria which may need antibiotic treatment.

While the researchers did not address the issue of overuse of antibiotics leading to growth of resistant strains of bacteria, the study concluded that it "supports current practice guidelines that discourage use of antibiotics for purulent rhinitis of less than seven to 10 days." The authors' summation was "to suggest initial management by non-antibiotic treatments or 'watchful waiting', and that antibiotics should only be used when symptoms have persisted for long enough to concern parents or patients".


See... British Medical Journal: Are antibiotics effective for acute purulent rhinitis? Systematic review and meta-analysis of placebo controlled randomised trials

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