Acute sinusitis: guide to selection of antibacterial therapy.

摘要: Primary care doctors should be cautious in the diagnosis and treatment of sinusitis as acute bacterial is currently over-diagnosed over-treated primary practice. The clinical difficult practice; however, a history purulent rhinorrhoea, secretions nasal cavity on examination, tooth pain, worsening symptoms following initial improvement, lack effect decongestants an elevated erythrocyte sedimentation rate are supportive evidence infection. Patients with for 7 days duration. Symptomatic sufficient patients mild symptoms. Three recent meta-analyses have concluded that newer broad-spectrum antibacterials not significantly more effective than narrow-spectrum agents, such amoxicillin or phenoxymethylpenicillin (penicillin V). However, because rapid increase antibacterial resistance Streptococcus pneumoniae Haemophilus influenzae, must take into account current recommendations treating infections caused by these organisms. Fourthly, sinus imaging studies recommended routine but may helpful selected cases. Finally, other pain medication, there little use adjunctive treatments, decongestants, symptom relief. study recurrent demonstrated who received fluticasone propionate addition to had higher success did receiving placebo antibacterials.