To the Editor.
—Reading the article by Dr Williams and colleagues,1 I was surprised to learn how weak the evidence of any benefit from antibiotic therapy in acute maxillary sinusitis is. If "a large number of head-to-head comparisons between antibiotics have shown that none is superior," a 10-day course of trimethoprim/sulfamethoxazole is no better than a 3-day course, and the only evidence of clinical efficacy of antibiotics comes from two trials—one of which reported nonsignificant clinical improvement2 and the other was restricted to children3—perhaps it is time to ask again the primary question: is antibiotic therapy of any benefit at all in acute maxillary sinusitis?
Shahar E. Three vs 10 Days of Trimethoprim/Sulfamethoxazole for Acute Maxillary Sinusitis. JAMA. 1995;274(17):1341. doi:10.1001/jama.1995.03530170021012