Acute Bacterial Sinusitis

1. Treatment

1.1. Approximately 85% of people with acute bacterial sinusitis have resolution of their symptoms within 7 to 15 days without antibiotic therapy

1.2. Watchful waiting

1.3. First-line antibiotics: amoxicillin or amoxicillin–clavulanate

1.4. Analgesics

1.5. Saline nasal irrigation

1.6. Intranasal glucocorticoids

1.7. Decongestants

2. Diagnostic testing

2.1. The diagnosis of acute bacterial sinusitis is based on the presence of purulent nasal discharge accom­panied by nasal obstruction; facial pain, pressure, or fullness; or both that persists for at least 10 days without improvement or worsens within 10 days after initial improvement

3. Risk factors

3.1. Asthma

3.2. Allergic rhinitis

3.3. Exposure to secondhand smoke

3.4. Smoking

4. Pathophysiologic etiology

4.1. Defined as symptomatic inflammation of the paranasal sinuses and nasal cavity,

4.2. In adults the most common pathogens that cause acute bacterial sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus

4.3. Only approximately 0.5-2.0% have sinusitis that progresses to acute bacterial sinusitis

5. Symptoms

5.1. Symptoms often persist for 10 days or longer without improvement

5.2. purulent nasal discharge accom­panied by nasal obstruction

5.3. Facial pain

5.4. Facial pressure

5.5. Headache

5.6. Malaise

5.7. Myalgia

5.8. Chills