What is acute bacterial sinusitis?

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Last updated: February 19, 2025View editorial policy

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From the FDA Drug Label

  1. 6 Acute Bacterial Sinusitis Moxifloxacin hydrochloride tablets are indicated in adult patients (18 years of age and older) for the treatment of acute bacterial sinusitis (ABS) caused by susceptible isolates of Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis
  • Acute bacterial sinusitis (ABS) is an infection caused by susceptible isolates of:
    • Streptococcus pneumoniae
    • Haemophilus influenzae
    • Moraxella catarrhalis 1

From the Research

Acute bacterial sinusitis is a clinical diagnosis characterized by symptoms such as unilateral facial pain or pressure, fever, and purulent nasal discharge, and is typically treated with antibiotics such as amoxicillin or amoxicillin-clavulanate for 5-10 days. The diagnosis of acute bacterial sinusitis is often based on the presence of cardinal features, including unilateral facial pain or pressure, fever greater than 102°F (39°C), and purulent nasal discharge with obstruction of the nasal passages 2.

Key Features of Acute Bacterial Sinusitis

  • Unilateral facial pain or pressure
  • Fever greater than 102°F (39°C)
  • Purulent nasal discharge with obstruction of the nasal passages
  • Symptoms persisting for 7 or more days, or worsening after 3 to 5 days

Treatment Approach

The treatment approach for acute bacterial sinusitis involves the use of antibiotics, with amoxicillin being as effective as amoxicillin-clavulanate as a first-line treatment for those without a beta-lactam allergy 2. For patients with a beta-lactam allergy, appropriate antibiotics include doxycycline or a respiratory fluoroquinolone. Supportive care, including the use of saline irrigation, nasal steroids or antihistamines, and decongestants, may help reduce the severity of symptoms.

Antibiotic Therapy

  • Amoxicillin: 500 mg three times daily for 5-10 days
  • Amoxicillin-clavulanate: 875/125 mg twice daily for 5-10 days
  • Doxycycline: 100 mg twice daily for 5-10 days
  • Fluoroquinolone: 500 mg once daily for 5-10 days

Important Considerations

Patients should seek immediate medical attention if they develop severe headache, visual changes, or signs of intracranial complications. Complications of rhinosinusitis are rare but may include orbital cellulitis, meningitis, and abscess, and computed tomography and referral to an otolaryngologist should be considered for patients with recurrent rhinosinusitis or concern about complications 2.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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