Usually viral and no antibiotics usually advised. In complicated cases antibiotics can be used. Consider ENT review.

Link to NICE Guidance

First Line

Penicillin V PO for 5 days

Co-amoxiclav IV if severe or worsening

Anaphylaxis (including severe skin reaction) to penicillin / cephalosporins

<12 years - Clarithromycin PO for 5 days

> 12 years - Doxycyline PO for 5 days


Only give antibiotics for persistent symptoms or purulent discharge for at least 7 days

CKS - Sinusitis