What is the Best Anti-Biotic for Acute Sinusitis? #generalphysician #antibiotics

Added: 2026-05-21

[00:00:00]Here is Shaver DO reaching out with another medical research update. This one concerns treatment of acute sinusitis in young adults.

[00:00:08]A study published in the Journal of the American Medical Association recently looked at comparing treatment of acute sinusitis with amoxicillin versus Augmentin at normal therapeutic dosages. For those who don't know, amoxicillin is just an old-school penicillin, relatively narrow spectrum, but quite effective for acute sinusitis. Augmentin is a drug that combines amoxicillin with another one called clavulanic acid that extends the spectrum of potential treatment. For some time now, the American College of Infectious Diseases has recommended Augmentin as first-line treatment for acute sinusitis, but has done so with a fairly weak recommendation.

[00:00:53]This study sought to compare to see if there were any additional treatment failures with amoxicillin versus Augmentin, as Augmentin has a lot less in the way of potential adverse effects.

[00:01:06]This study demonstrated very clearly that treatment failure rate was almost identical between the two of them. And this was a retrospective cohort study, but it was case controlled and involved over a half million individuals.

[00:01:21]So, this is reasonably good evidence that amoxicillin is every bit as effective as Augmentin for treatment of acute sinusitis in adults aged 18 to 45.

[00:01:32]The other thing that was interesting is we did see a significant increase in adverse effects like GI side effects, yeast infections, and Clostridium difficile infection secondary to Augmentin versus amoxicillin.

[00:01:48]With that in mind, I would recommend amoxicillin over Augmentin for acute sinusitis in the outpatient setting in healthy young adults. Hope this is helpful. If you'd like to see more of this, please do like and subscribe to the channel. If you have questions, feel free to fire away in the comments, and I'll see you next time.