Motive Medical Intelligence says 77.8% of 22,178 primary care clinicians it reviewed overprescribed antibiotics for acute sinusitis, though its announcement leaves the measure’s underlying methods unspecified.
The company said it analyzed claims from January 2023 through December 2024, covering clinicians in all 50 states and Washington, D.C. Motive reported that Minnesota and Louisiana were the only states to meet its 72% “best-practice” benchmark, with rates of 70.4% and 71.3%, respectively. South Dakota had the highest reported rate, at 83.8%, followed by Utah at 83.7% and Washington at 83.6%.
Motive’s Oct. 27 announcement does not name the claims database or give the number of sinusitis visits. It also does not explain the test used to classify a clinician as an overprescriber or how the company chose its benchmark. The release links no peer-reviewed paper.
The announcement describes acute sinusitis as an infection lasting fewer than 10 days but does not say whether that duration determined which claims were counted. The 2025 adult sinusitis guideline from the American Academy of Otolaryngology–Head and Neck Surgery defines acute rhinosinusitis by symptoms as well as duration: up to four weeks of purulent nasal drainage accompanied by nasal obstruction, facial pain, pressure or fullness.
The guideline says symptoms lasting fewer than 10 days without worsening are consistent with viral rhinosinusitis. It describes presumed bacterial cases as symptoms that persist without improvement for at least 10 days after upper respiratory symptoms begin, or worsen within 10 days after initially improving. For adults with uncomplicated bacterial rhinosinusitis when follow-up is assured, it recommends offering watchful waiting.
The Centers for Disease Control and Prevention (CDC) estimates that viruses cause 90% to 98% of rhinosinusitis cases. The agency says unnecessary antibiotics may not help and can expose patients to side effects, resistant infections and C. diff.
Motive Chief Medical Officer Rich Klasco called the pattern “a particularly frustrating example of low-value care.” The announcement also places inappropriate prescribing alongside more than $11 billion in annual U.S. health care costs. An American Academy of Otolaryngology–Head and Neck Surgery Foundation fact sheet assigns that annual figure to managing acute and chronic sinusitis overall; it gives no separate cost estimate for unnecessary antibiotic use.
