Acute Rhinosinusitis

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

Use adequate analgesia.

Non-Prescription Pad and Patient Information Leaflet

Prescribe xylometazoline 0.1% 2-3 drops into each nostril 2-3 times daily for 5 days.

Consider 7-day delayed or immediate antibiotic when purulent nasal discharge (NNT8).

Amoxicillin

500mg three times daily

1g if severe

7 days

or doxycycline (not suitable for those under 12 years)

200mg stat then 100mg daily

7 days

or phenoxymethylpenicillin

500mg four times daily

7 days

For persistent symptoms, use agent with anti-anaerobic activity: co-amoxiclav

625mg three times daily

7 days