BMJ  2006;333:395 (19 August), doi:10.1136/bmj.333.7564.395-a

Letter

Antibiotics and acute purulent rhinitis

There is no significant difference between antibiotics

The first 150 words of the full text of this article appear below.

EDITOR—Arroll and Kenealy suggest that amoxicillin may be the preferred antibiotic for purulent rhinitis.¹ The pooled effect of the two studies using amoxicillin was significant (relative risk 1.26 (95% confidence interval 1.11 to 1.45)), while cefalexin did not achieve significance in one study (relative risk 0.62 (0.26 to 1.47)). Altman and Bland have pointed out that reporting the P values of subgroups is not the correct method to compare the treatments, as it is confounded by the number of subjects in each group.² When the method suggested by Altman and Bland is used to compare the studies using amoxicillin directly to the study using cefalexin the relative risk reduction is 0.49 (0.20 to 1.18) (P = 0.11). This does not confirm a significant difference between the two antibiotics. Moreover, as the authors point out, half of the participants in the study by De Sutter et al had unilateral . . . [Full text of this article]

Manor View Practice, Bushey Health Centre, Bushey WD23 2NN chris.cates@nhs.net

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