What Is Sinusitis Symptoms And Treatments
- The goals of treatment of acute sinusitis are the reduction in signs and symptoms, achieving and maintaining patency of the ostia, limiting antimicrobial treatment to those who may benefit, eradication of bacterial infection with appropriate antimicrobial therapy, minimizing the duration of illness, prevention of complications, and prevention of progression from acute disease to chronic disease.
- Approximately 40% to 60% of patients with acute sinusitis will recover spontaneously (these are likely patients with viral sinusitis).
- Nasal decongestant sprays such as phenylephrine and oxymetazoline that reduce inflammation by vasoconstriction are often used in sinusitis. Use should be limited to the recommended duration of the product to prevent rebound congestion. Oral decongestants may also aid in nasal or sinus patency. To reduce mucociliary function, irrigation of the nasal cavity with saline and steam inhalation may be used to increase mucosal moisture, and mucolytics (e.g. guaifenesin) may be used to decrease the viscosity of nasal secretions. Antihistamines should not be used for acute bacterial sinusitis in view of their anticholineric effects that can dry mucosa and disturb clearance of mucosal secretions.
- Antimicrobial therapy is superior to placebo in reducing or eliminating symptoms, although the benefit is small.
- Amoxicillin is first-line treatment for acute bacterial sinusitis. It is cost effective in acute uncomplicated disease, and intial use of newer broad-spectrum agents is not justified.
- The current recommendations are 10 to 14 days, or at least 7 days, of antimicrobial therapy after signs and symptoms are under control.
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