Amoxicillin preferred for acute sinusitis in children

Amoxicillin and amoxicillin-clavulanate represent 65% of prescriptions to treat acute sinusitis in children, but health professionals have disagreed as to which of the two should be administered first.The results of a study involving more than 320,000 children who had received a prescription for one or the other of these two antibiotics seem to favour amoxicillin. Using an insurance company database, patients aged 0 to 17 were followed for up to 14 days after the start of treatment. It turned out the rate of treatment failure was very rare, regardless of whether the children received amoxicillin or amoxicillin-clavulanate.With both antibiotics combined, barely 2% of patients needed new treatment or suffered complications. About one in 1,000 cases required an emergency room visit or hospitalization, according to results published in JAMA.Read: Nasal discharge colour a poor guide for antibiotic use in acute sinusitisHowever, side-effects were more frequent with amoxicillin-clavulanate than with amoxicillin. Patients were 15% more likely to suffer from gastrointestinal disorders and the risk of candidiasis increased by 33% on amoxi-clav. Preschool-aged patients also had a greater risk of side-effects from this medication than the adolescent group.“Based on these data, health professionals should seriously consider prescribing amoxicillin as a first choice of defence against acute sinusitis,” noted Dr. Timothy Savage, first author of the study and epidemiologist at Brigham and Women’s Hospital in Boston.The main difference between the two products is the presence of clavulanic acid, which inhibits the action of beta-lactamases. It is therefore a broader spectrum antibiotic since it also targets beta-lactamase-producing bacteria. Researchers are concerned, however, that overprescribing amoxicillin-clavulanate could accelerate antimicrobial resistance. As the effectiveness rate is similar, the authors are confident that either antibiotic will clear the infection, but if possible, amoxicillin should be preferred.Read: If it’s not asthma, what is it?

Amoxicillin preferred for acute sinusitis in children

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