A simple test for children with sinusitis could slash antibiotic use, according to American scientists. 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. 

“Five million kids in the U.S. get prescribed antibiotics for sinusitis each year,” said study lead author Professor Nader Shaikh of the University of Pittsburgh. “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.”

With the target of developing a better tool to diagnose bacterial sinusitis, Professor 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 of 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 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. 

This new test could have major implications for public health, as overuse of antibiotics can encourage antibiotic resistance, which is an important public health threat. It is also important to note that antibiotics can have side effects, such as diarrhea and alter the microbiome, which we still don’t understand the long-term implications of.