SINUSITIS

Question 1

Sinusitis is the medical term for_______________

Answer 1

Sinusitis is the medical term for the inflammation of the lining of the sinuses

Question 2

WHAT ARE THE SYMPTOMS OF SINUSITIS

Answer 2

blocked nose, headache, facial pain and a reduced sense of smell.

Question 3

Sinusitis can be cause by a number of different factors including ___________

Answer 3

Sinusitis can be cause by a number of different factors including bacteria, irritants and allergies.

Question 4

WHAT IS THE PRIMARY CAUSE OF SINUSITIS?

Answer 4

BACTERIAL INFECTION

irritants

ALLERGY

Question 5

WHAT BACTERIA IS ASSOCIATED WITH SINUSITIS?

Answer 5

Streptococcus pneumoniae as the name suggests this organism is also the leading cause of community acquired pneumonia, Staphylococcus aureus and a number of Streptococci.

Question 6

WHAT IRRITANTS CAUSE SINUSITIS?

Answer 6

pesticides, air pollution, smoke and different chemicals

Question 7

WHAT SUPPORTIVE THERAPY FOR SINUSITIS?

AND WHY?

Answer 7

Analgesia
Response:
Yes, this patient is already taking paracetamol so you should advise them to continue this to control any pain experienced.

Fluids/Electrolytes
Response:
Yes, this patient has nasal congestion. Staying hydrated will help make any mucous fluid, this will relieve the congestion.

Nasal irrigation
Response:
Yes, although this sounds rather unpleasant, nasal irrigation is recommended by NICE for the treatment of sinusitis.

Question 8

WHEN SHOULD SINUSITIS BE TREATED?

Answer 8

IF THE patient symptoms have not resolved in 10 days AND IF THEY ARE also experiencing new symptoms. The BNF advises to prescribe a delayed prescription if symptoms fail to resolve in a further seven days.

Question 9

HOW TO TREAT SINUSITIS?

Answer 9

COULD BE CONSIDERED FOR TREATMENT IF SYMPTOMS PERSIST FOR 10 OR MORE DAYS WITH HIGH DOSE NASAL CORTICOSTEROID AND A BACKUP PRESCRIPTION COULD BE CONSIDERED

BUT SARAH SAID THAT A DELAYED ANTIBIOTIC PRESCRIPTION FOR SEVEN DAYS WOULD BE BETTER?

Question 10

ANTIBIOTIC TREATMENT FOR SINUSITIS?

Answer 10

No penicillin allergy
First line:
Non-life threatening symptoms: phenoxymethylpenicillin.
Systemically very unwell, signs and symptoms of a more serious illness, or at high-risk of complications: co-amoxiclav.

Second line (worsening symptoms despite 2 or 3 days of antibiotic treatment):
Non-life threatening symptoms: co-amoxiclav.
Systemically very unwell, signs and symptoms of a more serious illness or at high-risk of complications: consult local microbiologist.

Penicillin allergy or intolerance
First line: doxycycline or clarithromycin (erythromycin in pregnancy).
Second line (worsening symptoms despite 2 or 3 days of antibiotic treatment): consult local microbiologist.