Sinusitis- acute / chronic

Micro-organism

Acute - Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Group A Streptococcus

Chronic - Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Anaerobes

Duration

Acute: Duration 5-7 days

Acute Sinusitis - Notes
  • Many cases are viral.
  • Prescribe Topical Xylometazoline 0.1% 2 - 3 drops to each nostril 2 to 3 times daily for 5 days.
  • Send aspirate, discharge or antral washings
  • Consider sodium chloride douches
Acute Sinusitis - First line

Oral Amoxicillin 500mg 8 hourly for 7 days

(Use IV initially in severe/ febrile cases)

Acute Sinusitis - Penicillin Allergy

Oral Doxycycline 100mg 12 hourly for 5 days

Use IV initially in severe/febrile cases (seek specialist advice on IV antibiotic choice)

 

Chronic Sinusitis
  • Base treatment on culture results.
  • Consult Medical Microbiology and ENT surgeon
  • Take nasopharyngeal swab if no other samples obtained
  • Also consider intranasal steroids +/- decongestant and sodium chloride douches.