Sinusitis Bethesda: The Overuse of Antibiotics

By Dr. Rob Ivker, DO, ABIHM

Author of best-selling Sinus Survival

During the past decade there have been several published studies in highly respected medical journals documenting the ineffectiveness of antibiotics for treating acute sinusitis, more commonly known as a “sinus infection.” 

The latest study was published in the current Journal of the American Medical Association (JAMA).  Lead researcher, Dr. Jane Garbutt at the Washington University School of Medicine, provides a similar conclusion. Dr. Garbutt states, “There is not much to be gained from antibiotics.” The placebo group in the study actually had better results than the antibiotic test group after 10 days: 78% of antibiotic test group and 80% of the placebo group no longer had symptoms. The specific antibiotic evaluated in this study was Amoxicillin, by far the most heavily prescribed for sinus infections.

Another study published in JAMA in December 2007, concluded as follows: “The study should lead to a reconsideration of antibiotic use for acute sinusitis (sinus infection). The current view that antibiotics are effective can now be challenged, particularly for the routine cases which physicians treat," said lead author Dr. Ian Williamson of the University of Southampton in England.

In my clinical experience as a family physician for the past 40 years, I’ve not only observed the increased ineffectiveness of antibiotics in treating sinus “infections,” but more importantly, the exacerbation or worsening of the patient’s condition following multiple courses of broad-spectrum antibiotics. 

Since 1993 I've been treating patients suffering with severe chronic sinus symptoms and describing their condition as a candida or yeast overgrowth. The Mayo Clinic, in a landmark study published in September 1999, began using the term allergic fungal sinusitis to describe a very similar condition.  Their lead researcher, Eugene Kern, MD, concluded that “we need to look at the cause of chronic sinusitis as more than simply an anatomic or bacteriologic problem, but as an immune dysfunction mediated by a fungus.”

Chronic sinusitis is currently the world’s most common respiratory condition with more than 40 million sinus sufferers in the US alone.  Primary symptoms can include nasal and head congestion, post-nasal drip, headache, irritability, diminished energy, smell and overall quality of life.  Although it’s not a terminal disease most people with this diagnosis feel miserable a good bit of the time. And worst of all, most have been told by their physicians that they’ll have to learn to live with it.

Conventional medical treatment, consisting of antibiotics, corticosteroids, and sinus surgery (as a last resort) has been largely ineffective in curing this condition.  The vast majority of people with chronic sinusitis typically have from one to three or more acute “flare-ups” per year which they and their physicians assume is an infection, and in spite of the Mayo Clinic and the conclusion of the other important studies (two of which I’ve mentioned above) are reflexively prescribed antibiotics to treat the problem.  However, in the vast majority of cases these patients do NOT have a bacterial infection that would respond to an antibiotic.  It’s nearly always caused by either a virus (typically a cold virus) or some other allergic or environmental trigger causing severe inflammation of the mucous membrane lining the nose and sinuses. 

Rather than treat the underlying cause (inflammation) of these uncomfortable symptoms, antibiotics instead dramatically reduce the probiotic population – the beneficial bacteria living in a homeostatic relationship with candida (yeast/fungus) organisms in the respiratory and GI tract.  This reduction, coupled with the fact that the good bacteria are the “natural predators” of the candida (primary food source for the probiotics), then creates a significant imbalance and a candida overgrowth. 

Candida, living in normal balanced populations with probiotics poses no health hazards.  However, when they’re allowed to overgrow they begin to release toxins.  These toxins can have a devastating effect on the surrounding tissue, causing severe inflammation to the lining of the respiratory and GI tracts, as well as throughout the body, e.g. inflammation of joints and muscles, multiple food sensitivities and environmental allergies, extreme fatigue, weakening of the immune system.

For nearly twenty years I have been treating this condition in the majority of patients suffering with severe chronic sinusitis along with frequent episodes of acute sinusitis.  Although a definitive diagnosis remains elusive (we still do not have a consistently reliable laboratory test to confirm the diagnosis of candida overgrowth), I have repeatedly witnessed dramatic improvement in over 90 percent of my patients after administering an aggressive anti-fungal Candida treatment program. My own published study (Ivker, RS, Silvers, WS, Anderson, RA. Clinical observations and seven and one-half-year follow-up of patients using an integrative holistic approach for treating chronic sinusitis. Altern Ther Health Med. 2009;15(1):36-43) reinforces these findings. 

Antibiotics can certainly be life-saving and miraculously therapeutic when used appropriately. But the evidence seems abundantly clear…physicians are over-prescribing them, and in so doing are often creating more serious health problems for their patients. Unfortunately that’s not the only source of our antibiotics.  They can also be found in our food – beef, poultry, pork – and even in municipal water supplies.  They are surely a powerful class of drugs, but must be used with more discretion for they can also have catastrophic side-effects.  

According to a 2008 article in Clinical Infectious Diseases, more than 142,000 people are rushed to the emergency room each year from adverse reactions to antibiotics, and an estimated 70,000 of those cases may be a result of unnecessary antibiotic prescriptions. Over 100,000 Americans die every year from prescription drugs, many of which are antibiotics. In fact, medical treatment is the third leading cause of death (250,000 per year) in the U.S., behind heart disease and cancer.

There are over 13 million antibiotics prescribed each year in the U.S. for sinusitis. As a result of the overuse of these drugs we can develop a resistance, and sinus patients are often prescribed refills or a stronger antibiotic. They may find themselves feeling worse as a result of developing fungal sinusitis.

Children are more likely to suffer side effects such as diarrhea and abdominal pain from antibiotics. In addition, recent studies have repeatedly shown that antibiotics are not effective for most middle ear infections, while also increasing the likelihood of additional ear infections.

Fortunately there is a natural antibiotic-free treatment option that has worked well for my patients and readers of Sinus Survival for nearly 25 years. By adhering to the Sinus Survival Program, individuals can significantly reduce the severity and duration of a cold, and often prevent a sinus infection. However, if they do develop an infection, the same protocol is used, with similar results…a shorter and less severe sinus infection. And there are no harmful side-effects using this natural approach, which includes anti-infective and anti-inflammatory herbs, supplements, dietary recommendations, and nasal hygiene. 

Free access to the Sinus Survival solution is available at www.sinussurvival.com. There are nearly ½ million individuals who have at least significantly improved their sinus condition by applying the treatment information presented in the four editions of Sinus Survival. Many have actually cured their chronic and fungal sinusitis using this life-changing holistic approach. The current updated natural cold and sinus infection solution is now available for free on-line. Also included is my proven program for treating fungal and chronic sinusitis.

For physicians and practitioners, I have recently established the Respiratory Healer Network at www.respiratoryhealer.com to provide far greater access to the Sinus Survival Program. This includes an on-line training program enabling any health care practitioner who treats sinus patients to offer this successful holistic treatment option in their practice.  Just as I have been providing hope to people who feel depressed and hopeless with the misery of chronic sinusitis, now the Respiratory Healers will also be able to tell their patients, you don’t have to live with this!

Want some sinus treatment? Click the link and start getting rid of your "sinus infection" before it turns serious.