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Antibiotics caution

GPs should not prescribe anti-biotics for patients with acute purulent rhinitis because the risk of adverse effects outweighs potential benefits, a new study concludes.

The study, published online by the BMJ, found there was evidence of some effectiveness for antibiotics, in contrast to statements in some guidelines.

But the benefits were too modest to justify treatment given a substantial risk of side-effects and the threat of anti-

biotic resistance.

The meta-analysis of seven placebo-controlled studies found use of antibiotics had a modest effect on the time taken to resolve symptoms, with an 18 per cent increase in the likelihood of recovery in five to eight days.

But the risk of adverse events, which included vomiting, diarrhoea and abdominal pain, was increased by 46 per cent in the antibiotic group.

After weighing up numbers needed to treat, risk of side-

effects and risk of deciding not to treat, the researchers concluded there was 'not sufficient' reason to prescribe.

Study leader Professor Bruce Arroll, head of the department of general practice and primary health care at the University of Auckland, New Zealand, said the number of antibiotics still prescribed for self-limiting conditions was 'outrageous'.

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