This guidance summarises the NICE Sinusitis (acute) Guidance published in 2017, and the NICE RTIs Guidance published in 2008
Symptoms <10 days: do not offer antibiotics as most resolve in 14 days without, and antibiotics only offer marginal benefit after 7 days (NNT15).
Symptoms >10 days: no antibiotic, or back-up antibiotic if several of: purulent nasal discharge;+ severe localised unilateral pain; fever; marked deterioration after initial milder phase.
Systemically very unwell, or more serious signs and symptoms: immediate antibiotic.
Suspected complications: eg sepsis, intraorbital or intracranial, refer to secondary care.
Self-care: paracetamol/ibuprofen for pain/fever. Nasal decongestants or saline may help some.
No antibiotics - offer self care first line
First line for delayed:
200mg Stat the 100mg OD
Very unwell or worsening: