Sinusitis

Question 1

Sinusitis definition

Answer 1

Inflammation and/or infection of the mucosal lining of the nasal passage and paranasal sinuses

Question 2

Pathogens associated with sinusitis

Answer 2

S. pneumoniae, H. influenzae, M. catarrhalis

Question 3

Nonspecific symptoms of sinusitis: major

Answer 3

Purulent anterior nasal discharge, discolored posterior nasal discharge, nasal congestion or obstruction, facial congestion or fullness, decreased sense of smell, fever

Question 4

Nonspecific symptoms of sinusitis: minor

Answer 4

Headache, ear pain/pressure/fullness, halitosis, dental pain, cough, fatigue

Question 5

Treatment for viral sinusitis

Answer 5

decongestants, irrigation, mucolytics

Question 6

Treatment for bacterial sinusitis

Answer 6

NO decongestants or antihistamines

Question 7

When are ABX used for bacterial sinusitis?

Answer 7

Persistent symptoms ≥10 days without clinical improvement, severe symptoms ≥3-4 days at the beginning of illness, worsening symptoms after a typical URTI

Question 8

ABX for sinusitis

Answer 8

Amox/clav

Question 9

When to use high dose amox/clav

Answer 9

Area with high resistance, severe infections, daycare, age <2 or >65, recent hospitalization, ABX use within the last month, immunocompromised

Question 10

High dose amox/clav dose

Answer 10

2g PO BID or 90mg/kg/day PO divided twice daily

Question 11

Duration of ABX for sinusitis

Answer 11

Adults: 5-7 days
Kids: 10-14 days