Template
Acute bacterial sinusitis
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DiagnosisChoose one
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AntibioticChoose one
AdjunctsChoose any
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Follow-upChoose one
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Counseling
Symptoms should start to improve within a few days of starting the antibiotic.
Supportive careChoose anyParagraph
Counseling
Return precautions given including swelling or redness around the eye, vision changes, severe headache, stiff neck, confusion, high fever, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- Persistent or worsening or severe onset criteria
- No complications on exam
- Treat severe onset or worsening course
- Treat or observe 3 days for persistent illness
- Amoxicillin ± clavulanate first line
- Cefdinir, cefuroxime, cefpodoxime for allergy
- Ceftriaxone for vomiting/adherence
- Levofloxacin or clindamycin + cefixime for serious allergy or failure
- Reassess at 72 h; Table 4 changes
- Intranasal steroid, saline irrigation
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- Recurrent sinusitis evaluation (allergy, ENT)
- Complication return precautions
Used to decide, kept out of the note
- No imaging for uncomplicated sinusitis; CT for complications
- No TMP-SMX or azithromycin