Acute Sinusitis in Primary Care

Sinusitis is a common diagnosis in primary care, and around the third to fifth commonest reason for prescription of antibiotics. Yet, a recent Cochrane review of effectiveness of antibiotic for acute sinusitis concluded that antibiotics have only a small treatment effect with 80% of patients getting better within 2 weeks without antibiotic as against 90% in those given antibiotic. Why is this, and how can we target appropriate treatment to those who will benefit?