Acute Purulent Rhinosinusitis
exp date isn't null, but text field is
Bacterial infection with pus accumulation in one or more of the paranasal sinuses.
Investigations
- Anterior rhinoscopy – watery/purulent nasal discharge occasionally foul-smelling Nasal congestion
- Plain Paranasal Sinuses X-ray (Water’s, Caldwell views) Mucosal thickening; air-fluid levels
Pharmacological treatment
|
Clinical Diagnosis |
Antibiotic |
Duration |
Penicillin allergy |
Comments |
|
Acute Rhino-sinusitis
|
Antibiotics should ONLY be prescribed in SEVERE infection as this condition can have a viral cause.
|
|||
|
Acute Bacterial Rhinosinusitis (severe or persistent symptoms)
|
First line Amoxicillin/clavulanic acid oral 625mg every 8 hours
Second line Doxycycline oral 100mg every 12 hours |
5 days |
First line Clarithromycin oral 500mg every 12 hours
Second line Doxycycline oral 100mg every 12 hours |
|
|
Peri-orbital Cellulitis
|
Clindamycin IV 900mg every 8 hours
AND Ciprofloxacin oral 500mg every 12 hours
Oral Step down Clindamycin oral 450mg 4 times daily
AND Ciprofloxacin oral 500mg every 12 hours |
2 weeks |
Clindamycin IV 900mg every 8 hours
AND Ciprofloxacin oral 500mg every 12 hours
Oral step down Clindamycin oral 450mg 4 times daily
AND Ciprofloxacin oral 500mg every 12 hours |
- IV to oral switch when clinically suitable (24 – 48hrs)
|
Referral
Refer the following to ENT specialists
- Children with ethmoiditis presenting as an acute periorbital inflammation or orbital cellulitis must be hospitalized immediately.
- Adults with pronounced symptoms despite treatment. If sinusitis of dental origin is suspected Recurrent sinusitis (>3 attacks in a year) or chronic sinusitis (duration of illness of >12 weeks)