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

Therapy

  • 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

Therapy

Oral Amoxicillin 500mg 8 hourly for 7 days

(Use IV initially in severe/ febrile cases)

Acute Sinusitis - Penicillin Allergy

Therapy

Oral Doxycycline 100mg 12 hourly for 5 days

When an IV antibiotic is required in severe/febrile cases seek specialist advice

Chronic Sinusitis

Therapy

  • 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.