When considering oral broad-spectrum antibiotic therapy for acute sinusitis, clinicians often favor amoxicillin-clavulanate over amoxicillin alone. However, a large retrospective cohort study published in JAMA evaluated 521,244 adult patients diagnosed with acute sinusitis, of whom 65.5% were female, and found that amoxicillin alone was not associated with higher rates of treatment failure compared with amoxicillin-clavulanate. Importantly, patients treated with amoxicillin-clavulanate experienced a higher rate of adverse effects, highlighting the importance of balancing antimicrobial spectrum with potential medication-related harm and supporting more selective antibiotic stewardship practices.