Acute Rhinosinusitis

Acute Rhinosinusitis

CKS RS

Avoid antibiotics as 80% resolve in 14 days without; they only offer marginal benefit after 7days NNT15.

Use adequate analgesia.

Consider 7-day delayed or immediate antibiotic when purulent nasal discharge NNT8. In persistent infection use an agent with anti-anaerobic activity eg. co-amoxiclav.

Amoxicillin

 

500mg TDS

1g if severe

 

7 days

 

or doxycycline

200mg stat then 100mg OD

 

7 days

or phenoxymethylpenicillin

500mg QDS 

7 days

For persistent symptoms: co-amoxiclav

625mg TDS

7 days