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Antibiotic Risk May Outweigh Benefit for Purulent Rhinitis

New meta-analysis in support of current guidelines

FRIDAY, July 21 (HealthDay News) -- The risks of antibiotics, including gastrointestinal side effects and rashes, outweigh the benefits for treatment of acute purulent rhinitis, according to a meta-analysis published online July 20 in the BMJ.

Bruce Arroll, M.D., of the University of Auckland in New Zealand, and a colleague identified seven trials that compared antibiotics with placebo for acute purulent rhinitis lasting less than 10 days. They found that while antibiotics are effective, they can cause harm including gastrointestinal effects and rashes. Moreover, most patients get better without antibiotics. The findings support current guidelines that state that antibiotics should not be used as a first-line therapy for acute purulent rhinitis.

In the study, the number needed to treat ranged from 7 to 15, which means that, at best, six patients receive no benefit for every one patient with acute purulent rhinitis who is helped by the antibiotics. Further, the number needed to treat overlaps with the number needed to harm, which ranged from 12 to 78, the study showed.

"Our summation would be to suggest initial management by non-antibiotic treatments or 'watchful waiting,' and that antibiotics should be used only when symptoms have persisted for long enough to concern parents or patients," the study authors concluded.

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