Sinusitis

Question 1

Non-Pharm TX

Answer 1

• Steam inhalation
• Fluids
• Apply warm face cloth or heat of some kind
• Avoid irritants such as smoke (esp. if allergies)
• Saline drops or irrigation…

Question 2

Non Anti-Biotic Pharmacological TX

Answer 2

– analgesic
– Oral or topical decongestants- no evidence of benefit
– Intranasal steroid (not as beneficial in acute)
– May want to avoid 1st gen antihistamines (unless allergies are playing a role)
– Oral steroids: reduce edema and inflammation, but little evidence of benefit in acute

Question 3

Antibiotics should be given when…

Answer 3

– If still bothersome a week to 10 days after it first starts and meets clinical criteria, then antibiotics may be warranted
- Purulent and nasal discharge

Question 4

Adults First Line

Answer 4

– Amoxicillin 500mg -1000mg TID x 5 -10d

Question 5

Adults Second Line

Answer 5

mox/clav 500mg TID or 875mg BID
– 2nd gen cephalosporin – cefprozil, (other one)
– Doxycycline 100mg BID day 1, then 100mg OD
– Or 200mg Day 1, then 100mg BID
– Clarithromycin or azithromycin

Duration - 5-10 days

Question 6

Kids First Line

Answer 6

moxicillin 40 to 90mg/kg/day given BID or TID (max 3 g/day)

Question 7

Kids Second Line

Answer 7

– Amox/clav 40-90 mg/kg/d divided BID
– Cefuroxime 30 – 40 mg/kg/d divided BID
– Cefprozil 30mg/kg/day divided BID
– Duration: 10 days