# Antibiotic treatment for acute sinusitis and subsequent health care use and work absence: a nationwide registry study from Norway

## TL;DR

This study examines if antibiotic use for acute sinusitis in Norway reduces healthcare visits and work absence, finding only modest short-term effects.

## Contribution

The study provides real-world evidence on the impact of antibiotic treatment for acute sinusitis on healthcare use and work absence in a nationwide population.

## Key findings

- Antibiotic use was linked to fewer GP visits but more sick leave days in the first week.
- PcV showed slightly more GP visits and re-prescriptions compared to other antibiotics.
- No significant long-term reduction in healthcare use or work absence was observed with antibiotics.

## Abstract

Acute sinusitis is common in general practice. Although typically self-limiting, antibiotics are frequently prescribed despite guideline recommendations to restrict use. It remains unclear whether antibiotic treatment reduces subsequent health care use or work absence.

To assess how initial treatment with or without antibiotics for acute sinusitis is associated with subsequent health care use and work absence, and to compare phenoxymethylpenicillin (PcV) versus other antibiotics.

Nationwide registry-based observational cohort study of adults with acute sinusitis (ICPC-2: R75) diagnosed in Norwegian general practice 2012–2019. We compared GP visits, Ear, Nose, and Throat (ENT) specialist visits, repeat antibiotic prescriptions, and sick leave days in antibiotic-treated and untreated episodes. We estimated adjusted differences in outcomes between groups using linear regression (daily outcomes) and negative binomial regression (weekly counts).

We included 627 211 episodes from 413 449 patients. Antibiotics were prescribed in 59% of episodes; 53% received PcV. During the index week, antibiotic use was associated with 1.7 fewer GP visits, 0.1 fewer ENT visits, and 25.1 more sick leave days per 100 episodes. Corresponding figures for the following 4 weeks were: 0.9 fewer GP contacts, 10.7 fewer sick leave days, and 0.6 more antibiotic prescriptions. PcV was associated with slightly more GP visits and re-prescribing than other antibiotics.

Acute sinusitis is followed by a short-term increase in health care use and work absence. Initial antibiotic use was associated with modest short-term differences, but no meaningful reduction in overall follow-up. Findings are consistent with recommendations for restrictive prescribing and narrow-spectrum use when appropriate.