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Diagnosis and treatment of uncomplicated acute bacterial rhinosinusitis: Summary of the Agency for Health Care Policy and Research evidence‐based report
- Source :
- Otolaryngology–Head and Neck Surgery. 122:1-7
- Publication Year :
- 2000
- Publisher :
- Wiley, 2000.
-
Abstract
- Purpose: The goal was to critically examine evidence regarding the performance of diagnostic tests and the efficacy of antibiotic and other treatments for uncomplicated acute bacterial rhinosinusitis (ABR). Methods: Scientific literature was reviewed, and meta-analysis methods were used to assess diagnostic test and antibiotic efficacy. A decision analysis and cost-effective analysis were performed. Results: Although more sensitive than clinical examination for diagnosis of ABR, sinus radiograms are not cost-effective as an initial management strategy. Antibiotics reduce the incidence of clinical failures by one half compared to no treatment and, when coupled with clinical criteria-based diagnosis, present the most cost-effective treatment strategy. However, without antibiotics, symptoms in two thirds of patients improve by 14 days with no serious complications. The risk of treatment failure does not differ significantly between amoxicillin or folate inhibitors and newer, more expensive antibiotics. Conclusions: The current literature shows that treatment of uncomplicated ABR with amoxicillin or folate inhibitors and based on clinical criteria is the most cost-effective strategy. (Otolaryngol Head Neck Surg 2000;122:1-7.)
- Subjects :
- medicine.medical_specialty
medicine.drug_class
Cost-Benefit Analysis
Antibiotics
Physical examination
Treatment failure
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Health care
medicine
Humans
Sinusitis
Intensive care medicine
Rhinitis
Research evidence
Evidence-Based Medicine
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Amoxicillin
Bacterial Infections
Anti-Bacterial Agents
Otorhinolaryngology
030220 oncology & carcinogenesis
Acute Disease
Surgery
business
Decision analysis
medicine.drug
Subjects
Details
- ISSN :
- 10976817 and 01945998
- Volume :
- 122
- Database :
- OpenAIRE
- Journal :
- Otolaryngology–Head and Neck Surgery
- Accession number :
- edsair.doi.dedup.....c847ab099237bda39ed136963e3caa45