title: Diagnosis and treatment of acute sinusitis in the primary care setting: A retrospective cohort.
abstract: OBJECTIVE
  Our objectives were to characterize the quality of acute sinusitis care and to identify nonclinical factors associated with antibiotic use for acute sinusitis. We hypothesized that we would identify provider-level factors associated with antibiotic use.
  
  
  METHODS
  Retrospective cohort at a single academic institution.
  
  
  METHODS
  We developed and clinically annotated an administrative dataset of adult patients diagnosed with acute sinusitis between January 1, 2005, and December 31, 2006. We used identify factors associated with receipt of antibiotics.
  
  
  RESULTS
  We find that 66.0% of patients with mild symptoms of short duration are given antibiotics, and that nonclinical factors, including the individual provider, the provider's specialty, and the presence of a medical trainee, significantly influence antibiotic use. Relative to internal medicine providers, family medicine providers use fewer antibiotics, and emergency medicine providers use more antibiotics for acute sinusitis.
  
  
  CONCLUSIONS
  Antibiotics continue to be overused for patients with mild acute sinusitis of short duration. Nonclinical characteristics, including the individual provider, the provider's specialty, and the presence of a medical trainee, significantly influence use of antibiotics for acute sinusitis.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Pynnonen
authors.affiliation: Department of Otolaryngology.
authors.forename: Shana
authors.initials: S
authors.lastname: Lynn
authors.affiliation: Department of Otolaryngology.
authors.forename: Hayley E
authors.initials: HE
authors.lastname: Kern
authors.affiliation: Department of Otolaryngology.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Novis
authors.affiliation: Department of Otolaryngology.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Akkina
authors.affiliation: Michigan Institute for Clinical and Health Research.
authors.forename: Nahid R
authors.initials: NR
authors.lastname: Keshavarzi
authors.affiliation: Department of Pediatrics and Communicable Diseases, Department of Internal Medicine, University of Michigan Medical School; Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan, U.S.A.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D000067490:Prescription Drug Overuse / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012189:Retrospective Studies; D012852:Sinusitis / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Sinusitis; adult; provider; retrospective cohort; survey