Sinusitis management Flashcards
When should a patient with sinusitis be referred to hospital?
Refer to hospital if there are symptoms and signs of severe systemic infection, intraorbital or periorbital problems, or intracranial complications.
What should be done for symptoms of sinusitis lasting less than 10 days?
Do not offer an antibiotic. Provide advice on managing symptoms and when to seek medical advice.
What advice should be given to patients with acute sinusitis?
Acute sinusitis is usually caused by a virus and takes 2-3 weeks to resolve. Symptoms such as fever can be managed using paracetamol or ibuprofen. Nasal saline or nasal decongestants may provide some relief. Medical advice should be sought if symptoms worsen rapidly, do not improve in 3 weeks, or if the patient becomes systemically unwell.
What over-the-counter treatments can provide relief for acute sinusitis?
Nasal saline or nasal decongestants can provide some relief. Intranasal corticosteroid can be given for congestion.
When should medical advice be sought for acute sinusitis?
Seek medical advice if symptoms worsen rapidly, do not improve in 3 weeks, or if the patient becomes systemically unwell.
What is the likely cause of sinusitis symptoms lasting more than 10 days but less than 4 weeks?
Sinusitis symptoms lasting more than 10 days but less than 4 weeks are commonly caused by a bacterial infection.
What treatment should be considered for adults and children over 12 years old with sinusitis lasting more than 10 days?
Consider high-dose nasal corticosteroid for 14 days (e.g., mometasone).
Should antibiotics be prescribed immediately for sinusitis lasting more than 10 days but less than 4 weeks?
Consider no antibiotic prescription or a back-up prescription, as antibiotics are unlikely to change the course of the illness.
What is the first-line antibiotic for sinusitis, and for how long should it be taken?
Phenoxymethylpenicillin for 5 days is the first-line antibiotic.
What should be given if the patient with sinusitis is allergic to penicillin?
Clarithromycin should be given if the patient is allergic to penicillin.
What is the second-line antibiotic for sinusitis?
Co-amoxiclav is the second-line antibiotic.
What advice should be given to patients with sinusitis regarding seeking medical advice?
Advise patients to seek medical advice if they develop complications or if their symptoms don’t improve or worsen.
sinusitis management summary
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