Saline Nasal Irrigation More Effective than Spray for Chronic Sinus Symptoms

According to a new study in the latest issue of the Archives of Otolaryngology — Head & Neck Surgery, saline irrigation treatments show greater efficacy versus saline spray for providing short-term relief of chronic nasal and sinus symptoms.

In the United States, 29.5 million people 18 years of age and older are affected by sinusitis [1]. Millions more are affected by other types of allergic and non-allergic rhinitis (meaning irritation and inflammation of the mucosal membrane of the nose). Some people can reduce symptom severity using medication, including antihistamines and anti-inflammatory drugs. Antibiotics are frequently prescribed for acute and chronic sinusitis. However, their use far outweighs the predicted incidence of bacterial infection, suggesting that antibiotics are overprescribed for sinus infections. Regardless of the medication used however, for many patients, symptoms persist.

Antibiotics Overprescribed for Sinus Infections

Healthcare use of antibiotics far outweighs the predicted incidence of bacterial causes of acute and chronic sinusitis. That’s the conclusion of a new study published in the March 2007 issue of Archives of Otolaryngology – Head and Neck Surgery [1].

Antibiotics are only effective against bacterial infection. Many sinus infections are due to viral infection, allergies or hormonal changes. Physicians try to avoid antibiotic use to reduce the emergence of dangerous resistant bacterial strains, such as methicillin-resistant Staphylococcus aureus. However, most patients with sinus congestion want immediate relief and, because more effective drugs for chronic sinusitis are lacking, demand antibiotics.


The four-year prospective study found Americans made on average 4.25 million visits to healthcare facilities per year for sinus infection between 1999 and 2002. At least one antibiotic was prescribed in nearly 83% of cases of acute sinusitis and 70% of cases of chronic sinusitis. Antibiotics were prescribed more often than antihistamines, nasal decongestants, corticosteroids, and antitussive, expectorant, and mucolytic agents (order reflects the frequency of recommended medication).