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BMJ 2006;333 (5 August), doi:10.1136/bmj.333.7562.0
Antibiotics should not be used as first line treatment for acute purulent rhinitis because of their gastrointestinal toxicity, even though they are probably effective. Arroll and Kenealy (p 279) conducted a meta-analysis of seven randomised controlled trials in adults and children. The relative risks for benefits and harms with the antibiotics were 1.18 and 1.46 respectively. Antibiotics may be used when the symptoms continue long enough to concern patients, the authors add.
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