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