Rhinosinusitis, Acute Bacterial (ABRS)
Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: J01 DESCRIPTION Inflammation or infection of one or more of the sinuses that occurs most often after a viral infection or with allergic rhinitis. DIAGNOSTIC CRITERIA Child with an acute upper respiratory tract infection presenting with: persistent illness (nasal discharge, facial pain/pressure, or dayt
General and supportive measures
ICD-10 code: J01
DESCRIPTION
Inflammation or infection of one or more of the sinuses that occurs most often after a viral infection or with allergic rhinitis.
DIAGNOSTIC CRITERIA
Child with an acute upper respiratory tract infection presenting with:
- persistent illness (nasal discharge, facial pain/pressure, or daytime cough lasting more than 10 days without improvement), a worsening course (worsening or new onset of nasal discharge, daytime cough, or pain/fever after initial improvement),
OR
- severe onset (concurrent fever [temperature ≥ 39°C], pain and purulent nasal discharge for at least 3 consecutive days).
GENERAL AND SUPPORTIVE MEASURES
- Steam inhalation to liquefy and remove secretions blocking the nose.
MEDICINE TREATMENT
For infection:
- Amoxicillin, oral, 45 mg/kg/dose 12 hourly for 10 days.
Maximum dose: 1.5 g 12 hourly.
Note: For poor response to amoxicillin therapy, or in patients who have received amoxicillin in the last 30 days:
- Amoxicillin/clavulanic acid, oral, 45 mg/kg/dose of amoxicillin component, 12 hourly for 5–10 days (amoxicillin/clavulanic acid in a ratio of 14:1).
- Maximum dose of amoxicillin component: 1.5 g 12 hourly.
For pain and fever:
If allergic rhinitis is suspected, See: Rhinitis, Allergic/ Allergic Rhinosinusitis.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 17: Ear Nose & Throat, 17.11 Rhinosinusitis, Acute Bacterial (ABRs)