Acute bacterial rhinosinusitis in adults: part II. Treatment.

摘要: Although most cases of acute rhinosinusitis are caused by viruses, bacterial is a fairly common complication. Even though patients with recover promptly without it, antibiotic therapy should be considered in prolonged or more severe symptoms. To avoid the emergence and spread antibiotic-resistant bacteria, narrow-spectrum antibiotics such as amoxicillin used for 10 to 14 days. In mild disease who have beta-lactam allergy, trimethoprim/sulfamethoxazole doxycycline options. Second-line if patient has moderate disease, recent use (past six weeks), no response treatment within 72 hours. Amoxicillin-clavulanate potassium fluoroquinolones best coverage Haemophilus influenzae Streptococcus pneumoniae. hypersensitivity fluoroquinolone prescribed. The evidence supporting ancillary treatments limited. Decongestants often recommended, there some support their use, although topical decongestants not than three days rebound congestion. Topical ipratropium sedating antihistamines anticholinergic effects that maybe beneficial, but clinical studies this possibility. Nasal irrigation hypertonic normal saline been beneficial chronic sinusitis serious adverse effects. corticosteroids also may treating sinusitis. Mist, zinc salt lozenges, echinacea extract, vitamin C proven benefit rhinosinusitis.