This week we dive into acute rhinosinusitis focusing on diagnosis and discussing the absence of utility for antibiotics in most patients.


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Tags: ENT, Rhinosinusitis, Sinusitis, URI





Show Notes
Take Home Points

Sinusitis is a clinical diagnosis. Patients typically present with purulent nasal discharge and facial pain or other URI symptoms.
The vast majority of patients with acute rhino sinusitis will be viral in nature and will not benefit from antibiotics
Patients with prolonged symptoms, more than 7-10 days, without improvement or continued fevers past 2-3 days should be considered for antibiotic treatment as should those who are immunocompromised.

Show Notes
Melio FR, Berge LR. Upper Respiratory Tract Infections, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 75: p 965-79.
The NNT: Antibiotics for Clinically Diagnosed Acute Sinusitis in Adults
The NNT: Antibiotics for Radiologically-Diagnosed Acute Maxillary Sinusitis
Lemiengre MB et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev. 2012. PMID: 23076918
Ahovuo-Saloranta A et al. Antibiotics for acute maxillary sinusitis. Cochrane Database Syst Rev. 2008. PMID: 18425861

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