Sinusitis- acute / chronic
Micro Organisms
Acute - Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Group A Streptococcus
Chronic - Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Anaerobes
Duration
Acute: Duration 5-7 days
Acute Sinusitis - Notes
- Many cases are viral.
- Prescribe Topical Xylometazoline 0.1% 2 - 3 drops to each nostril 2 to 3 times daily for 5 days.
- Send aspirate, discharge or antral washings
- Consider sodium chloride douches
Acute Sinusitis - First line
Oral Amoxicillin 500mg 8 hourly for 7 days
(Use IV initially in severe/ febrile cases)
Acute Sinusitis - Penicillin Allergy
Oral Doxycycline 100mg 12 hourly for 5 days
When an IV antibiotic is required in severe/febrile cases seek specialist advice
Chronic Sinusitis
- Base treatment on culture results.
- Consult Medical Microbiology and ENT surgeon
- Take nasopharyngeal swab if no other samples obtained
- Also consider intranasal steroids +/- decongestant and sodium chloride douches.