CHICAGO, Oct 16: When it comes to treating sinus problems, newer and more expensive antibiotics may not be any better than older cheaper ones, scientists said on Tuesday.

The report from Washington University School of Medicine in St. Louis was based on an analysis of a pharmaceutical database containing information on thousands of adults diagnosed in 1996 and 1997 with acute sinusitis. The condition is an inflammation of the membrane lining the air-filled cavities in bones surrounding the nose.

In all 17 drugs were prescribed. Three of them were older and cheaper first-line antibiotics such as amoxicillin (a type of penicillin), trimethoprin-sulfamethoxazole and erythromycin, and 14 newer and more expensive second line drugs such as clarithromycin, azithromycin, amoxicillin/clavulanate, cefuroxine and ciprofloxacin.

The study, published in this week’s Journal of the American Medical Association, said the success rate for 17,329 patients who received the older antibiotics was 90.1 percent compared to 90.8 percent for 11,773 receiving newer, more costly drugs — a difference of 0.7 percentage point.

“Due to the higher expense and potential for the development of resistant bacteria, physicians should avoid prescribing second-line antibiotics as the initial antibiotic treatment” for sinusitis, the study said.

“It seems that there is a significant opportunity to improve patient care and decrease costs through more judicious use and selection of antibiotics,” it added.

The average total direct charge for patients receiving a first-line antibiotic was $68.98 compared to $135.17 for a second-line one, a difference of $66.19, the study said. “This difference was due entirely to the difference in charge of antibiotics and not other charges,” it added.

The research was funded by Express Scripts Inc., of St. Louis, an independent pharmacy benefits manager. The journal said the company’s research programs “are not obligated to any health care provider or pharmaceutical company.”—Reuters