title: Recommended and prescribed symptomatic treatment for acute maxillary sinusitis in Finnish primary care.
abstract: We studied the use of symptomatic medication in the treatment of acute maxillary sinusitis (AMS) in primary care and whether this use is in accordance with national guidelines. The data was collected annually in the Antimicrobial Treatment Strategies (MIKSTRA) Program in 30 primary health care centres throughout Finland during one week in November in the years from 1998 to 2002. Physicians and nurses collected the data about the diagnoses, prescription-only medicines and over the counter medicines prescribed or recommended for all patients with an infection during the study weeks. The MIKSTRA data comprised of 23.002 first consultations for an infection: 2.448 patients were diagnosed as having AMS. Altogether, 41% of them received some symptomatic medicine. Antihistamines with or without sympathomimetics were the most commonly prescribed or recommended symptomatic medicines (23% of the patients). For comparison, systemic antibacterial agents were prescribed for 93% of the AMS patients. We conclude that Finnish physicians recommend or prescribe more symptomatic medication without proven efficacy for AMS than recommended by the national guidelines. Especially, the use of antihistamines with or without sympathomimetics, mostly the combination of acrivastine and pseudoephedrine, was common although antihistamines were recommended only for patients with allergy or nasal polyps.
authors.affiliation: National Public Health Institute, Department of Bacterial and Inflammatory Diseases, Turku, Finland. johanna.pulkki@ktl.fi
authors.forename: Johanna
authors.initials: J
authors.lastname: Pulkki
authors.forename: Ulla-Maija
authors.initials: UM
authors.lastname: Rautakorpi
authors.forename: Solja
authors.initials: S
authors.lastname: Huikko
authors.forename: Pekka
authors.initials: P
authors.lastname: Honkanen
authors.forename: Timo
authors.initials: T
authors.lastname: Klaukkas
authors.forename: Marjukka
authors.initials: M
authors.lastname: Mäkelä
authors.forename: Erkki
authors.initials: E
authors.lastname: Palva
authors.forename: Risto
authors.initials: R
authors.lastname: Roine
authors.forename: Hannu
authors.initials: H
authors.lastname: Sarkkinen
authors.forename: Pentti
authors.initials: P
authors.lastname: Huovinen
authors.forename: Helena
authors.initials: H
authors.lastname: Varonen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005387:Finland; D019983:Guideline Adherence; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000188:drug therapy*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D013566:Sympathomimetics / Q000627:therapeutic use
chemical_list: D006634:Histamine H1 Antagonists; D013566:Sympathomimetics