A simple medical test for children with sinusitis could slash antibiotic use, according to a new study.
Taking a nasal swab – similar to a Covid test – to check for three types of bacteria In youngsters believed to have the common condition can indicate whether antibiotics are likely to be effective or not, say American scientists.
Study lead author Professor Nader Shaikh, of the University of Pittsburgh, said: “Five million kids in the U.S. get prescribed antibiotics for sinusitis each year.
“Our study suggests that only half of these kids see an improvement in symptoms with antibiotic use, so by identifying who they are, we could greatly reduce unnecessary antibiotic use.”
Sinusitis, which is an inflammation or swelling of the sinuses, can cause congestion, runny nose, discomfort and difficulty breathing.
Doctors often prescribe antibiotics, which target only bacterial infections, to treat the condition – even though it may be caused by viruses.
Prof. Shaikh said: “Sinusitis is one of the most common diseases we see in children.
“But it’s difficult to diagnose because it’s based on the duration of symptoms: if the child has a runny nose or congestion for more than 10 days, we suspect sinusitis.
“For an ear infection, we can look inside the ear; for pneumonia, we listen to the lungs. But for sinusitis, we have nothing to go on from a physical exam. That was very unsatisfying to me.”
With the target of developing a better tool to diagnose bacterial sinusitis, Prof Shaikh and his team enrolled around 500 children with sinusitis symptoms from six centers across the U.S. and randomly assigned them to receive either a course of antibiotics or placebo.
The research team also took swabs from inside the nose – similar to a Covid-19 test – from each child and tested for the three main types of bacteria involved in sinusitis.
Youngsters who tested positive for the bacteria had better resolution of symptoms with antibiotic treatment compared to those who did not have bacteria
The findings, published in the Journal of the American Medical Association (JAMA), suggest that testing for bacteria could be a simple and effective way to detect children who are likely to benefit from antibiotics and avoid prescribing the drugs to those who wouldn’t.
Prof. Shaikh said: “If antibiotics aren’t necessary, then why use them?
“These medications can have side effects, such as diarrhea, and alter the microbiome, which we still don’t understand the long-term implications of.
“Overuse of antibiotics can also encourage antibiotic resistance, which is an important public health threat.”
He says a common belief among parents and doctors is that yellow or green snot signals a bacterial infection.
Although several small studies have suggested that nasal discharge color is not meaningful, Prof Shaikh and his team formally tested the idea by asking parents to identify the hue of their child’s snot on a color card.
He said: “If kids with green or yellow discharge benefitted more from antibiotics than those with clear-colored discharge, we would know that color is relevant for bacterial infection.
“But we found no difference, which means that color should not be used to guide medical decisions.”
Prof. Shaikh added that a possibility could be development of rapid antigen tests that work like Covid-19 home testing kits.
The research team also plan to delve deeper into the data from the study to see whether there could be another type of biomarker in nasal discharge indicating the presence of bacteria that would be easier to test for.
Produced in association with SWNS Talker