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The causes are diverse--from rhinitis and rhinosinusitis to drugs and structural/mechanical abnormalities. Here's how to provide patients with relief. Nasal obstruction is one of the most common reasons that patients [...]

Practice changer Stop prescribing antibiotics for adults with a clinical diagnosis of acute sinusitis, unless the patient has severe symptoms. Antibiotics have little if any positive effects on the severity [...]

Practice recommendations * Pain is not a sufficient criterion to diagnose sinusitis clinically (B). * Purulence makes sinusitis more likely (B). * Antibiotics are of moderate benefit in acute sinusitis [...]

* OBJECTIVE To compare the efficacy of amoxicillin vs placebo in patients with an acute upper respiratory tract infection and purulent rhinorrhea. * STUDY DESIGN Double-blind randomized placebo-controlled trial. * [...]

* EVIDENCE-BASED ANSWER The inability of clinical criteria to accurately differentiate bacterial from viral disease makes routine use of antibiotics inappropriate for clinically diagnosed maxillary sinusitis (strength of recommendation [SOR]: [...]

Ortho-McNeil has received FDA approval for the use of Levaquin (levofloxacin) as a five-day, 750-mg once-daily regimen in the treatment of acute bacterial sinusitis. A clinical study determined that this [...]

Gargutt JM, Goldstein M, Gellmen E, Shannon W, Littenberg B. A randomized, placebo-controlled trial of antimicrobial treatment for children with clinically diagnosed acute sinusitis. Pediatrics 2001; 107:619-25. * BACKGROUND The [...]

Snow V, Mottur-Pilson C, Hickner JM. Principles of appropriate antibiotic use for acute sinusitis in adults. Ann Intern Med 2001; 134:495-97. * BACKGROUND Antibiotic use is an important factor in [...]

Meltzer EO, Charous BL, Busse WW, Zinreich SJ, Lorber RR, Danzig MR. Added relief in the treatment of acute recurrent sinusitis with adjunctive mometasone furoate nasal spray. J Allergy Clin [...]

Government and physicians collaborate to stem tide of antibiotic resistance. WASHINGTON -- The first comprehensive guidelines for antimicrobial treatment of acute bacterial rhinosinusitis recommend limiting the use of antibiotics and [...]

(gatifloxacin, Bristol-Myers Squibb) A fluoroquinolone for ABECB, acute sinusitis, CAP, uncomplicated and complicated urinary tract infections, pyelonephritis, uncomplicated urethral and cervical gonorrhea; also for acute uncomplicated rectal infections in women [...]

Three days of antibiotic therapy is usually adequate as initial treatment for acute bacterial sinusitis in adults, said Dr. Richard A. Jacobs, of the department of medicine and infectious diseases [...]

Sinusitis resolves more often and more quickly when patients are treated with antibiotics, but two-thirds of patients would recover anyway without the drugs, according to the Agency for Health Care [...]

In 1998 the British Journal of General Practice published a study by W. Stalman (1) entitled "The end of antibiotic treatment in adults with acute sinusitis-like complaints in general practice?" [...]

I read with interest the CMAJ article by Venekamp and colleagues, (1) but I disagree with the authors' findings that suggest systemic corticosteroid monotherapy had no clinically important benefit in [...]

Reference Van Buchem FL, Knottnerus JA, Schrijinemaekers VJJ Peeters ME Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis. Lancet 1997; 349:683-7. Clinical question Does amoxicillin benefit patients [...]

OCTOBER INSTANT POLL RESULTS Do you prescribe antibiotics for acute rhinosinusitis? Only if the symptoms are severe or persist for > 7 days 65% Rarely or never 17% Often or [...]

* You're majorly congested and your head and cheeks are throbbing. You're sure it's a sinus infection-which means antibiotics, right? Not so fast. A new study published in the Journal [...]

Anyone who has felt the pressure of a weeklong sinus infection won't be happy to hear it, but a study finds that a commonly prescribed medicine doesn't clear up such [...]

NEW YORK -- The fastest-growing area of the saline nasal spray product segment has been sinus irrigation. Allergy and chronic sinusitis sufferers drove up irrigation product sales 98% in the [...]

The allergy/sinus market is expected to grow to $3.5 billion in sales by 1995, up from $1.9 billion in 1989. Primary market products (designed just for allergy or sinus relief) [...]

No. Fluoroquinolones have no benefit over beta-lactams for acute bacterial rhinosinusitis (ABRS). The more important and relevant questions are whether we can distinguish ABRS from viral sinusitis (not very well) [...]

* Bottom line No. According to this study--the largest published and nonpharmaceutically funded randomized controlled trial--antibiotics and nasal steroids were equal to placebo treatment for acute maxillary sinusitis in adults [...]

Neither an antibiotic nor a steroid nasal spray is effective against acute bacterial sinusitis, according to a randomized study of 240 adults in the United Kingdom. These findings add to [...]

Sharp HJ, Denman D, Puumala S, Leopold DA. Treatment of acute and chronic rhinosinusitis in the United States, 1999-2002. Arch Otolaryngol Head Neck Surg. 2007;133:260-265. The percentage of cases of [...]

Antibiotics are prescribed in 83% of physician visits for acute rhinosinusitis and in 70% of visits for chronic rhinosinusitis, far more than is indicated by the expected rates of bacterial [...]

GAITHERSBURG, MD. -- A Food and Drug Administration advisory panel has recommended against approving the fluoroquinolone gemifloxacin for treating acute bacterial sinusitis, because of the noninferiority design of the studies [...]

The Food and Drug Administration approved a 5-day course of Levaquin (levofloxacin) with 750-mg once-daily tablets to treat adults with acute bacterial sinusitis caused by Streptococcus pneumoniae, Haemophilus influenzae, and [...]

Acute bacterial sinusitis is usually preceded by a viral infection of the upper respiratory tract. Because experts agree that the indiscriminate use of antibiotics for sinusitis has contributed to the [...]

TORONTO -- Knowing when and what type of antibiotics to use is the key to treating acute bacterial rhinosinusitis, Dr. Joel Bernstein said at an international conference on allergy and [...]

Nebulized antibiotics appear to clear the infections of many patients who have chronic sinusitis, following functional endoscopic sinus surgery, reported Dr. Winston C. Vaughan and Dr. Gerard Carvalho of Stanford [...]

SAN DIEGO -- Evidence from a survey of patients seen for acute rhinosinusitis in a family medicine clinic suggests that providing a backup antibiotic prescription can significantly reduce antibiotic usage [...]

Dolor RJ. Witsell DL, Hellkamp AS, et al. Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. The CAFFS trial: a randomized controlled trial. JAMA 2001; [...]

There is no clinical benefit to prescribing second-line antibiotics for acute uncomplicated sinusitis, according to results of a study by Dr. Jay F. Piccirillo of Washington University, St. Louis, and [...]

DeFerranti SD, Ioannidis JP, Lau J, Anninger WV, Barza M. Are amoxicillin and folate inhibitors as effective as other antibiotics for acute sinusitis? A meta-analysis. BMJ 1998; 317:632-7 Clinical question [...]

Allergy sufferers may welcome the first autumn frost with high hopes that their symptoms will finally abate. But just when they think they can breathe easy, along comes the virus [...]