Nose Infections

Question 1

What bacteria can cause acute sinusitis?

Answer 1

Streptococcus pneumoniae
Haemophylus influenzae
Moraxella catharrhalis
Staphylococcus aureus

Question 2

When should antibacterial therapy be offered to patients with acute sinusitis?

Answer 2

• Signs and symptoms of a more serious illness
• Those at high-risk of complications
• When bacterial sinusitis is suspected?

Question 3

First line treatment for acute sinusitis in a patient with no penicillin allergy?

Answer 3

Phenoxymethylpenicillin:
- 500 mg PO 4 times a day for 5 days

Systemically unwell or high-risk complications:
co-amoxiclav:
- 500/125 mg PO 3 times a day for 5 days

Question 4

Second line treatment for acute sinusitis in a patient with no penicillin allergy?
(give when symptoms are worsening despite 2 or 3 days of antibiotic treatment)

Answer 4

Co-amoxiclav:
- 500/125 mg PO 3 times a day for 5 days

or

Consult local microbiologist

Question 5

First line treatment for acute sinusitis in a patient with penicillin allergy?

Answer 5

Doxycycline:
- 200 mg PO for 1 dose, then 100 mg OD for 5 days in total

or

Clarithromycin:
- 500 mg PO BD for 5 days