Acute Bacterial Sinusitis

Question 1

Initial Abx treatment for Acute Bacterial Sinusitis

Answer 1

Amoxicillin w/ or w/o clavulanate

Question 2

Presumptive diagnosis of ABS can be made in a child with URI in what 3 settings?

Answer 2

1. persistent discharge and/or daytime cough for 10 days without improvement
2. worsening course or new sxs (fever, cough) after initial improvement
3. severe onset (concurrent fever and nasal discharge) for 3 days

Question 3

When should a CT scan be ordered for a child with possible ABS?

Answer 3

• should NEVER be used to distinguish ABS from URI

- ONLY obtain when signs of CNS or orbital involvement

Question 4

What are the 3 most commonly involved organisms in ABS?

Answer 4

Streptococcus pneumoniae
Haemophilus influenza
Moraxella catarrhalis

Question 5

If Amoxicillin cannot be used for ABS treatment, what is a good alternative for treatment?

Answer 5

2nd/3rd Generation cephalosporins

Ex: cefdinir, cefuroxime, cefpodoxime