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Sinusitis

Infection Sinusitis Brief outline/clinical setting Sinusitis refers to inflammation of the sinuses. Acute sinusitis is commonly caused by respiratory viruses, which then predisposes to secondary bacterial infection. Allergy, trauma and dental infection may also predispose to acute bacterial sinusitis.  Indications for antibiotics in patients with acute bacterial sinusitis include: Symptoms &

Infection Sinusitis
Brief outline/clinical setting Sinusitis refers to inflammation of the sinuses. Acute sinusitis is commonly caused by respiratory viruses, which then predisposes to secondary bacterial infection. Allergy, trauma and dental infection may also predispose to acute bacterial sinusitis. 
Indications for antibiotics in patients with acute bacterial sinusitis include:
  1. Symptoms > 10 days and < 3 months
  2. Severe lasting purulence or fever
  3. Worsening of symptoms (secondary sickening) occurs in < 10 days
Aetiologies/organisms
  1. Respiratory viruses
  2. Haemophilus influenzae
  3. Streptococcus pneumoniae
  4. Moraxella catarrhalis
  5. Staphylococcus aureus
Optimal antimicrobial selection Amoxicillin 500mg 8 hourly OR 875mg 12 hourly
                               OR
Amoxicillin/clavulanate 500mg/125mg 8 hourly OR 875mg/125mg 12 hourly
Duration 5 – 10 days
Alternative if allergic/not available Telithromycin 800mg daily for 5 days OR 
Levofloxacin 500mg 12 hourly or 750mg daily OR
Moxifloxacin 400mg daily X 5 days
Rationale Revised Upper Respiratory Tract Infection (URTI) Guideline for South Africa - 2014
Level of evidence  
Link to Guideline  

Drugs mentioned

NeoHealth® ID 23877 · updated 3/27/2024