I was impressed by the article by Dr Graham Worrall on acute sinusitis.1 I was pleased to agree with his opinion that the evidence supports the withholding of antibiotics except when there is a strong suspicion of bacterial superinfection and that first-line antibiotics without specific anaerobic or Gram-negative coverage, such as amoxicillin, offer the best choice if such treatment is required. I also agree that the option of a delayed prescription is a reasonable one for the case cited. I was surprised, however, to read that the agent prescribed in the case study was amoxicillin-clavulanate, which is at least 50% more expensive and has a far greater profile of side effects and complications than amoxicillin!
Footnotes
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Competing interests
None declared
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