From the Guidelines
The treatment for sinusitis is primarily antibiotic therapy, with the goal of eradicating the causative pathogens, providing symptomatic relief, and restoring sinus function 1.
Treatment Options
- Acute Bacterial Sinusitis: The primary therapy is a 10- to 14-day course of antibiotics, with amoxicillin being the first-line treatment 1.
- Chronic Sinusitis: Treatment is less clear-cut, but may involve a minimum of 3 weeks of antibiotic therapy, nasal decongestants, and intranasal corticosteroids 1.
Additional Therapies
- Intranasal Corticosteroids: May be used to decrease inflammation in both acute and chronic sinusitis 1.
- Decongestants: Such as oxymetazoline hydrochloride, may be used to relieve nasal congestion, but their efficacy is not well established 1.
- Surgical Intervention: May be necessary in cases of chronic sinusitis, particularly when anatomic obstruction is present 1.
Important Considerations
- Diagnosis: Should be based on clinical presentation, and imaging studies such as CT scans may be used to confirm the diagnosis 1.
- Antibiotic Resistance: Should be considered when selecting antibiotic therapy, with amoxicillin-clavulanate being a suitable alternative in cases of suspected resistance 1.
From the Research
Treatment Options for Sinusitis
- The primary treatment for acute bacterial sinusitis is antibiotic therapy, with the goal of providing adequate coverage against the most important pathogens, such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 2, 3.
- Guidelines recommend a 10- to 14-day treatment course, but some studies suggest that short-course (< or =5 days) antibiotic therapy may have equivalent or superior efficacy compared with traditional longer therapies 2.
- The choice of antibiotic should take into account current recommendations for treating infections caused by resistant organisms, such as penicillin-resistant S. pneumoniae and beta-lactamase-producing H. influenzae and M. catarrhalis 3, 4.
- Symptomatic treatment, including pain medication, decongestants, and saline irrigation, may be sufficient for patients with mild symptoms, while patients with severe symptoms or moderate symptoms of >7 days duration may require antibacterial treatment 4, 5.
Antibiotic Therapy
- Amoxicillin or amoxicillin-clavulanate are commonly recommended as first-line treatments for acute bacterial sinusitis 3, 4.
- Alternative antibiotics, such as cefuroxime, cefpodoxime, or cefdinir, may be used in patients who are allergic to penicillin or unresponsive to amoxicillin 3.
- Macrolides, such as clarithromycin or azithromycin, may be used in cases of serious drug allergy 3.