New Study Finds Widespread Antibiotic Overuse for Sinus Infections Across the U.S.

• National analysis of 22,178 primary care clinicians across all 50 states and the District of Columbia identifies persistent gaps between clinical guidelines and prescribing practices
• More than three-quarters of clinicians overprescribe antibiotics for acute sinusitis, with state-by-state statistics
• Unnecessary antibiotic use exposes patients to potential side effects, contributes to antibiotic resistance, and costs the U.S. healthcare system more than $11 billion a year

SAN FRANCISCO, Oct. 27, 2026 /PRNewswire/ -- Despite decades of guidelines urging watchful waiting without antibiotics, primary care clinicians continue to overprescribe antibiotics to patients with acute sinusitis — a sinus infection that lasts less than 10 days — according to a new analysis by healthcare data analytics leader Motive Medical Intelligence.

The study covered 22,178 primary care clinicians across all 50 states and the District of Columbia, revealing that more than three-quarters of clinicians, 77.8%, continue to prescribe antibiotics to patients with acute sinusitis. The findings, based on claims data from Jan. 2023 through Dec. 2024, highlight a persistent gap between recommended care and prescribing practices for this common condition.

While performance varies somewhat from state to state, inappropriate prescribing is rampant nationwide. Only two states — Minnesota (70.4%) and Louisiana (71.3%) — met Motive's 72% best-practice benchmark. At the other end of the spectrum, South Dakota (83.8%), Utah (83.7%), and Washington (83.6%) posted the highest overuse rates in the nation.

Unnecessary antibiotics expose patients to potential side effects, add costs, and contribute to antibiotic resistance.

A Common Condition, Costly Practice

Acute sinusitis is one of the most common reasons people seek medical care. About 12%, or roughly 1 in 8, of U.S. adults report having sinusitis each year, and the condition drives more than 30 million annual diagnoses, according to data from the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF). Most acute sinusitis cases are viral, according to the Centers for Disease Control and Prevention (CDC), and the  American College of Physicians (ACP) and the CDC recommend that clinicians "reserve antibiotic treatment for acute rhinosinusitis for patients with persistent symptoms for more than 10 days…"

Yet, inappropriate antibiotic prescribing for acute sinusitis accounts for nearly 20% of all outpatient antibiotic prescriptions and costs the U.S. healthcare system more than $11 billion a year. 

"Prescribing an antibiotic for acute sinusitis is a particularly frustrating example of low-value care, as the evidence has been known for years," said Rich Klasco, MD, Chief Medical Officer of Motive.

Why this Practice Persists

So why has this practice proved so intractable?

Part of the answer lies in uncertainty. Doctors fear missing a serious infection, even though such concerns are largely unfounded, according to systematic reviews. Misperceptions by doctors and patients also play a role. According to the ACP and CDC, many patients have unrealistic expectations about the efficacy of antibiotics for sinusitis, and many physicians fear that their patient satisfaction scores will suffer if they withhold antibiotics.

Most acute sinus infections resolve on their own, and unnecessary antibiotics can expose patients to avoidable risks.

"But patients don't need to leave empty-handed, and doctors don't need to fear patient dissatisfaction," added Dr. Klasco. "Saline rinses, nasal steroids, and a clear plan for when to come back are the right choice for most sinus infections."

Dr. Julie Scherer, Chief Solutions Officer at Motive, and the lead data scientist for the study, said, "Measuring prescribing at the clinician level gives health systems a concrete way to close the gap and move toward the care that professional societies have recommended for years."

Perhaps the best advice comes from the AAO-HNSF, which recommends "Clinicians should offer watchful waiting (without antibiotics) for adults with uncomplicated ABRS [sinusitis] with assurance of follow-up."

Study Methodology

The study was conducted using Motive's Practicing Wisely clinical analytics system, which measures individual clinician performance across appropriateness of care, quality, and waste. By mapping closed-claims data to evidence-based standards of care, Motive's expert team can measure individual clinician decisions at the point of care, share actionable insights back to the clinician, and help improve clinical performance to drive positive change across the U.S. health system. Practicing Wisely delivers unique insights into how individual clinicians perform against evidence-based standards, benchmarked against their peers, enabling health plans and systems to more accurately assess risk, reduce waste, move toward quality care, and drive high-value outcomes at scale.

About Motive Medical Intelligence

Motive Medical Intelligence is redefining healthcare performance analytics with an emphasis on transparency, physician trust, and real-world actionability. Motive is the partner of choice for organizations committed to eliminating low-value care and thriving in value-based care models. Through its proprietary Practicing Wisely solution, Motive is helping the industry eliminate the $400 billion in annual waste in the U.S. health system, advancing the transition to high-value, patient-centered care, and achieving the quadruple aim. Learn more here.

Media: 
Supreme Communications for Motive Medical Intelligence
[email protected]

SOURCE Motive Medical Intelligence