Læknablaðið - 15.09.2010, Blaðsíða 23

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An evaluation of diagnosis and treatment of acute
sinusitis at three health care centers
Objective: The objective of this study was to evaluate the
diagnosis and treatment of acute sinusitis at three health
care centers in northern and eastern lceland.
Material and methods: Information on all those diagnosed
with acute sinusitis (ICD 10 J01.0, J01.9) in the year
2004 at the communal health care centers in Akureyri,
Husavik and Egilsstadir was obtained retrospectively
from computerized clinical records. Key factors used for
diagnosis and treatment were recorded. In order to obtain
an equal distribution in population size only about one-
third of the diagnoses made in Akureyri were included in
the search (the first ten days of every month).
Results: The search yielded a total of 468 individuals.
The average incidence of acute sinusitis was found to be
3.4 per 100 inhabitants per year. Adherence to clinical
guidelines (albeit from other countries) regarding diagnosis
of bacterial sinusitis was nearly nonexistent. There were
considerable differences found between health care
centers as to whether x-rays were used for diagnostic
purposes. Blood tests were hardly used at all. The disease
was diagnosed over the telephone in 28% of the cases
(Husavik 38%, Akureyri 32%, Egilsstadir 10%). Over 90%
of all individuals diagnosed with acute sinusitis received
antibiotics, regardless of symptom duration. The antibiotics
most often prescribed were Doxycyclin and Amoxicillin.
Conclusions: The incidence of acute sinusitis in
these three communities seems to be similar to other
western countries. Acute bacterial sinusitis seems to be
overdiagnosed and the use of antibiotics is in no context
with clinical guidelines. Our results support the hypothesis
that physicians tend to regard acute sinusitis as a bacterial
disease, and treat it accordingly.
Oskarsson JP, Halldorsson S.
An evaluation of diagnosis and treatment of acute sinusitis at three health care centers. Icel Med J 2010; 96: 531-5
Key words: Sinusitis, diagnosis, treatment, antibiotics
Correspondence: Jón Pátmi Óskarsson, palmio@internet.is
Barst: 21. janúar 2010, - samþykkt til birtingar: 1. júlí 2010
Hagsmunatengsl: Engin
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Framkvæmdanefnd Heimilislæknaþingsins:
Anna Kristfn Jóhannsdóttir formaður fræðslunefndar.
Nanna Kristinsdóttir
Áslaug Gunnarsdóttir
Jón Steinar Jónsson.
Björg Þ. Magnúsdóttir
Þórarinn Ingólfsson
Erla Gerður Sveinsdóttir
LÆKNAblaðið 2010/96 535