Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin with or without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis
Percentage of patients aged 18 years and older with a diagnosis of acute bacterial sinusitis that were prescribed amoxicillin, with or without clavulanate, as a first line antibiotic at the time of diagnosis.
ACP does not support QPP measure 332: "Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin with or without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis." While it is clinically important to promote appropriate use of broad-spectrum antibiotics, numerator specifications do not align with Infectious Diseases Society of America (IDSA) clinical recommendations on treatment of acute, bacterial rhinosinusitis. IDSA recommends amoxicillin-clavulanate as the first line of treatment in patients diagnosed with bacterial sinusitis. Also, the measure specifications do not include exclusion criteria for patients who do not tolerate amoxicillin. About 30%-40% of patients are bacterial resistant to amoxicillin therapy alone. Developers should update the measure specifications to encourage prescription of amoxicillin-clavulanate as first-line therapy in patients diagnosed with bacterial sinusitis.