718 Management Of Acute Sinusitis: Result Of A French Cohort Study

Sylvie Blazejewsk - INSERM U657; Université Bordeaux 2, Bordeaux, France
J.L. Demeaux - Université Bordeaux 2, Bordeaux, France
S. Lignot - INSERM U657; Université Bordeaux 2, Bordeaux, France
P. Gehanno - Hôpital Bichat, Paris, France
J. Franck - General Practitioner, Rouen, France
P. Blin - INSERM U657; Université Bordeaux 2, Bordeaux, France
Objective: To describe acute sinusitis management by general practitioners (GPs) and Ear, Nose, and Throat specialists (ENTs) in France. Methods: A prospective observational cohort study of patients with acute sinusitis was carried with a representative sample of GPs and ENTs. Patients were included in two 4-week periods (March and September 2005). Statistical analysis was weighted to take into account acute sinusitis activity and national distribution of GPs and ENTs. Results: 1174 GPs and 120 ENT included 5238 and 455 patients respectively. The median acute sinusitis case load of GPs and ENTs was respectively 8.4 and 6.7 cases per month. Extrapolation to all GPs and ENTs in France allows estimating that GPs see 97% of the patients with acute sinusitis versus 3% for ENTs. The mean delay between symptoms onset and inclusion was 4.5 days for GPs and 8.6 for ENTs. Localisations were maxillary (47% for GPs and 61% for ENTs), ethmoido-frontal (29% and 12%), pansinusitis (23% and 24%), and sphenoid (0.7% and 1.6%). Antibiotics were prescribed to 92% of GPs patients and 93% of ENTs patients. The most frequent antibiotics were cefpodoxime 18%, amoxicillin clavulanate 18% and telithromycin 12%. The most frequently co-prescribed drugs were analgesics (51% for GPs and 15% for ENTs), corticosteroids (48% and 62%), symptomatic medicines (46% and 20%) and NSAIDs (18% and 7.5%). Conclusions: Most of patients with acute sinusitis (97%) were treated by GPs. There were minor differences in patient characteristics and management between GPs and ENTs.
Management of acute sinusitis: result of a French cohort study