Author Affiliations: National Center for Immunization and Respiratory Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Hicks and Fairlie); and Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City (Dr Hersh).
We appreciate Lai and Liao's interest in our study.1 While we were unable to distinguish between acute bacterial and viral sinusitis in our study, other studies have evaluated the frequency of bacterial infection of the sinuses. A viral upper respiratory tract infection (URI), or the common cold, is the most frequent cause of acute sinusitis, and secondary bacterial infection of the sinuses following a viral URI is estimated to occur in approximately 0.5% to 2% of adult cases.2- 4 The prevalence of bacterial infection during acute sinusitis episodes is estimated to be only 2% to 10%, whereas viral causes account for the remainder.4 Our study showed that antibiotics were prescribed for more than 80% of adults diagnosed as having acute sinusitis,1 despite evidence that few are of bacterial origin and that approximately 70% of patients improve without antibiotic therapy in clinical trials.2,4,5
Hicks LA, Hersh AL, Fairlie T. Acute Sinusitis in Adults—Reply. JAMA Intern Med. 2013;173(10):934. doi:10.1001/jamainternmed.2013.571