Adult Sinusitis Guidelines Updated — Physician’s First Watch

Medical News |
April 2, 2015

Adult Sinusitis Guidelines Updated

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM

The American Academy of Otolaryngology—Head and Neck Surgery Foundation has updated its 2007 guidelines on managing adult sinusitis.

The guidelines, published in Otolaryngology—Head and Neck Surgery, stress shared decision-making between clinicians and patients, particularly in determining whether to try watchful waiting for uncomplicated acute bacterial sinusitis or to prescribe antibiotics right away.

Some of the other changes in recommendations include:

  • To relieve the symptoms of acute bacterial rhinosinusitis, clinicians may recommend analgesics, topical intranasal steroids, nasal saline irrigation, or a combination.

  • When antibiotics are prescribed, the recommended first-line treatment is amoxicillin with or without clavulanate for 5–10 days.

  • For chronic rhinosinusitis, clinicians should assess the patient for other chronic conditions (e.g., asthma) that would modify treatment; should check for nasal polyps; may test allergy and immune function; and should not prescribe topical or systemic antifungal treatment.

Reader Comments (6)

J. Garich, Pharm.d. Other Healthcare Professional, Pharmacology/Pharmacy, VCC

AHQR has a good summary of different guidelines for rhino sinusitis including the IDSA guideline. Other antibiotics discussed are doxycycline and septa.

Kenneth Henry Other Healthcare Professional, Family Medicine/General Practice

Most certainly consider GERD in the etiology and prevention of adult sinusitis.

Margaret McAllister PhD, FNP-BC Other Healthcare Professional, Family Medicine/General Practice, UMass Boston

Reflux is another confounding factor contributing to chronic sinusitis and post nasal drip.

pamela lepera Physician, Oncology

An emerging cause of chronic sinusitis may be NTM infection.
The American Thoracic Society and the Infectious Diseases Society of America discourage the use of swabs and recommend use of suction device of the mid meatus . interpretation of the results must consider risk for spurious recovery of non tuberculous mycobacterial due to endoscope contamination because glutaraldehyde may not be sufficient to eliminate this organism (Mycobacterium chelonae-abscessus complex associated with sinopulmonary disease, northeastern USA. Emerg Infect Dis. 2011;17:1692–700).

Linda Mann RNP Other Healthcare Professional, Internal Medicine, Retired

Nontuberculous Mycobacterium (NTM) and/or Bronchiectasis should be considered when sinusitis is resistant to treatment.

mahmoud salem Physician, Family Medicine/General Practice, PHC KSA

it is very important for every physician to update his knowledge

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