Description
Rhinosinusitis is the inflammation of the nasal passages and sinuses extending beyond 7-10 days . It can be acute (lasting less than 4 weeks), subacute (4-12 weeks), chronic (over 12 weeks), or recurrent (four or more episodes per year).
Signs and Symptoms
- Runny nose
- Postnasal drip
- Nasal congestion
- Sinus pain or pressure
- Headache
- Toothache
- Loss of smell
- Halitosis (bad breath)
- Cough (more common in children)
Treatment
Supportive
- Nasal saline irrigation to reduce congestion and flush out
Pharmacological
Pain Management: Acute Rhinosinusitis
- Paracetamol (Acetaminophen):
- Adults: 500 mg to 1 g every 4-6 hours as needed (maximum 4 g per day).
- Children 6-12 years: 250-500 mg every 4-6 hours as needed (maximum 2 g per day).
- Children 1-5 years: 120-250 mg every 4-6 hours as needed (maximum 1 g per day).
- Ibuprofen:
- Adults: 200-400 mg every 4-6 hours as needed (maximum 1.2 g per day).
- Children 4-7 years: 150 mg every 8 hours (maximum 7.5-10 mg/kg daily).
- Children 7-12 years: 200 mg every 8 hours (maximum 7.5-10 mg/kg daily).
Nasal Decongestants:
- Pseudoephedrine:
- Adults: 60 mg every 4-6 hours (maximum 240 mg per day).
- Children over 6 years: 30 mg every 4-6 hours (maximum 120 mg per day).
- Xylometazoline hydrochloride
- Child 6–11 years: 1–2 drops 1–2 times a day as required for maximum duration of 5 days, 0.05% solution to be administered into each nostril
- Child 12–17 years: 2–3 drops 2–3 times a day as required for maximum duration of 7 days, 0.1% solution to be administered into each nostril
- Adult: 2–3 drops 2–3 times a day as required for maximum duration of 7 days, 0.1% solution to be administered into each nostril
Nasal Corticosteroids:
- Fluticasone:
- Adults: 100 mcg once daily into each nostril, can be increased to 100 mcg twice daily if necessary
- Children: 50 mcg once daily into each nostril, can be increased to 50 mcg twice daily if necessary
- Mometasone:
- Adults: 100 mcg once daily into each nostril, can be increased to 200 mcg daily if necessary
- Children: 50 mcg once daily into each nostril, can be increased to 100 mcg daily if necessary
Antibiotics: Acute Rhinosinusitis (If bacterial infection is suspected)
- Amoxicillin:
- Adults: 500 mg every 8 hours or 1 g every 12 hours for 7-10 days.
- Children: 50 mg/kg/day in divided doses every 8 hours (not to exceed 1 g per dose) for 7-10 days.
- Doxycycline:
- Adults: 100 mg every 12 hours for 7-10 days