Module 9 Part 2 Sinusitis – Adult Acute

Question 1

What is the recommended treatment approach for viral sinusitis?

Answer 1

Viral sinusitis doesn’t require antibiotics.

Question 2

Which bacteria are commonly associated with bacterial sinusitis?

Answer 2

Common bacteria include Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus.

Question 3

What are the first-line and second-line antibiotic choices for bacterial sinusitis in adults?

Answer 3

First line: Amoxicillin (500 mg three times a day). Second line: Amoxicillin/Clavulanate, Cefprozil, Cefuroxime, Doxycycline, Clarithromycin, Azithromycin, and Trimethoprim/Sulfamethoxazole.

Question 4

What is the recommended duration of antibiotic therapy for acute bacterial sinusitis, and how is successful therapy defined?

Answer 4

Generally 10 days. Successful therapy means significant symptom improvement at 10 days, not necessarily complete symptom disappearance.

Question 5

What are the red flags for urgent referral in cases of acute sinusitis?

Answer 5

Systemic toxicity, altered mental status, severe headache, swelling of the orbit, or changes in visual acuity.

Question 6

What additional management strategies can be employed for sinusitis?

Answer 6

Saline rinses or sprays, oral decongestants, and intranasal steroids may help reduce symptoms. Avoid using topical decongestants for more than 3-4 days. Antihistamines are not proven to be effective.

Question 7

What role do antimicrobials play in the management of chronic sinusitis?

Answer 7

Antimicrobials typically have a limited role in chronic sinusitis, and surgical evaluation may be needed in cases of recurrent or chronic sinusitis.

Question 8

Why is it essential to consult local resistance patterns for antibiotic choice?

Answer 8

Increased resistance rates with certain antibiotics may make them less desirable, and selecting antibiotics should consider local resistance patterns.