Washington, DC -- It can happen suddenly: pain or pressure around the eyes, a postnasal drip, fever, bad breath. These are hallmark signs of an illness that strikes millions of Americans each year – sinusitis. And while it is one of the top five reasons patients see visit their doctor, treating sinusitis is complicated in part because it’s often not known if the cause is viral or bacterial.
Sinusitis is an infection or swelling of the lining in the sinus cavities. The sinuses are in the hollow spaces in the cheeks and around the eyes. The illness can come and go fast, or hang around for weeks.
“When you have sinusitis, it’s a crummy feeling,” says Daniel Merenstein, MD, a family medicine physician at Georgetown University Medical Center. “As a doctor, I want nothing more than to ease its symptoms, but treating sinusitis is tricky.”
If the sinusitis is caused by a bacterial infection, antibiotics could be effective, but there is no easily available and cost effective diagnostic test to determine if a virus or bacteria triggered the illness.
Merenstein says primary care providers often prescribe antibiotics for more than 90 percent of their patients with acute rhinosinusitis.
“For a majority of patients, antibiotics provide little clinical benefit,” he says. “However, there appears to be a subset of patients that may benefit from antibiotics.”
Determining which patients would benefit from antibiotics and other treatments including steroids, is why Merenstein, director of research program in the department of family medicine at GUMC, and several international colleagues are launching a comprehensive treatment study.
“In addition to comparing the effectiveness of antibiotics with or without steroids, we’ll also add the use of an alternative treatment called saline nasal irrigation or neti-pots,” adds Merenstein.
Planning for the new study is well underway. Merenstein and colleagues have secured funding from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, but other resources will be necessary before the trial opens for volunteers.
“These are very important questions to ask that could lead to real improvement in how we treat sinusitis,” says Merenstein. “It’s also important to know how to judiciously use antibiotics to help control antibiotic resistance, to reduce the risk of creating a super bug that grows resistant to treatment.”
Merenstein reports no related financial interests. The project described is supported by award number R34AI085193 from the National Institute of Allergy and Infectious Diseases (NIAID). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIAID or the NIH.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through Georgetown’s affiliation with MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university’s sponsored research funding.
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