KP Patients with Sinusitis Benefit from Collaborative Research

By Dani K. Dodge Medlin 

As an emergency physician, Adam L. Sharp, MD, often sees patients come through the doors of Kaiser Permanente’s Los Angeles Medical Center with runny noses, headaches, and sinus pain. Some of the patients explain they’ve had the miserable conditions for several days and ask for antibiotics, an often-used treatment for sinusitis symptoms.

Dr. Sharp is compassionate, caring, and conscientious, but he usually says no. Scientific evidence doesn’t support the use of antibiotics in the vast majority of these cases. 

Giving patients antibiotics for sinusitis symptoms is more likely to do harm than good, Dr. Sharp explains to the patients. Traditional treatments questioned

The campaign and others have called into question the routine use of radiology tests and antibiotics for acute sinusitis. Sharp’s research team set out to examine the use of CT scans and antibiotic prescriptions for Kaiser Permanente Southern California members with sinusitis symptoms.

The study found that physicians were generally following clinical practice guidelines when it came to use of CT scans, but needed to improve in the area of prescribing antibiotics. 

Over-prescription of antibiotics has been a stubborn problem in health care, and this research is part of Kaiser Permanente’s ongoing efforts to strengthen antibiotic stewardship and the organization’s overall commitment to continuous quality improvement. The data collected helps demonstrate to clinicians the size of the problem, and helps focus our comprehensive efforts to correct it.

Identifying a need to improve antibiotic stewardship for sinusitis encounters allowed us to educate other Kaiser Permanente Southern California prescribing clinicians and integrate clinical decision support into the electronic health records even before the research results were published, Dr. Sharp said. Working hand-in-hand with primary care, urgent care, and emergency care clinicians expedites things and allows our organization to keep up with changing guidelines that will help our patients stay healthy. 

Earlier this month, Kaiser Permanente was part of a White House Forum on Antibiotic Stewardship at which it and other health-care providers around the country pledged to reduce over-prescription to fight the emergence of drug-resistant superbugs.

Researchers examine treatment patterns

In the study – published in the Choosing Wisely® campaign. 

The research found:

         Of the    89.2 percent filled an antibiotic prescription, and

   1.1 percent had a CT scan.

         A comparison of primary care, urgent care, and emergency care showed improvement was needed in all settings.

 

  

So when are antibiotics necessary? That’s something to discuss with a physician, but some signs to watch for are symptoms that last more than a week, a fever higher than 101.5 degrees, and a hot red rash.