Acute Sinusitis

Avoid antibiotics as 80% resolve in 14 days without; and they only offer marginal benefit after 7 days.

Use adequate analgesia.

Non-Prescription Pad and Patient Information Leaflet and NICE Information for the Public

Local symptoms ≤10 days: no antibiotic

Local symptoms with no improvement >10 days:

- consider high dose nasal steroid for 14 days;

- no antibiotic or delayed antibiotic

NB If no nasal discharge - sinusitis is unlikely.

Systemically very unwell or high risk of complications: immediate antibiotic

Amoxicillin

500mg 3 x daily

(use 1g if severe)

child dose

5 days

OR Phenoxymethylpenicillin

500mg 4 x daily

child dose

5 days

Penicillin Allergy: 

Doxycycline (not suitable for those under 12 years)

200mg on Day 1

then 100mg daily

5 days

Penicillin Allergy if <12 years

Clarithromycin

child dose

5 days