Although evidence to support antibiotic treatment for acute rhinosinusitis is limited, antibiotics are commonly used. This randomized, placebo-controlled study was conducted to determine the incremental effect of amoxicillin treatment over symptomatic treatments for 166 adults with uncomplicated, clinically diagnosed acute rhinosinusitis. A ten-day course of either amoxicillin (1,500 mg/d) or placebo was administered in three doses per day. All patients received a 5- to 7-day supply of symptomatic treatments for pain, fever, cough, and nasal congestion to use as needed. The mean change in Sinonasal Outcome Test-16 scores was not significantly different between groups on days three or ten but differed at day seven favoring amoxicillin (mean difference between groups of 0.19; 95% CI, 0.024 to 0.35). There was no statistically significant difference in reported symptom improvement at days three or ten, whereas at day seven more participants treated with amoxicillin reported symptom improvement (P = 0.02). No between-group differences were found for any other secondary outcomes and no serious adverse events occurred. The authors concluded that among patients with acute rhinosinusitis, a ten-day course of amoxicillin compared with placebo did not reduce symptoms at day three of treatment. JAMA. 2012 Feb 15;307(7):685-92. PMID: 22337680
