rhinosinusitis%20-%20acute,%20bacterial
RHINOSINUSITIS - ACUTE, BACTERIAL
Acute bacterial rhinosinusitis is the mucosal inflammation of the nose and paransal sinuses caused by bacteria lasting >10 days for up to 4 weeks or symptoms worsening for 5-7 days within 10 days.
It is often preceded by a viral upper respiratory tract infection.
Signs and symptoms are nonspecific and typically difficult to differentiate from viral upper respiratory tract infection.
There is fever with nasal obstruction/congestion or anterior and/or posterior purulent drainage, with or without facial pressure/pain/fullness and reduction/loss of smell.
Streptococcus pneumoniae and unencapsulated strains of Haemophilus influenzae cause half of acute rhinosinusitis cases.

Otolaryngologist Referral

  • Reassure and educate the patient about the nature of URTI and ABRS and expected duration of illness
  • Encourage the patient to implement home self-care measures to provide relief of symptoms and prevent the occurrence of ABRS
  • Maintain adequate hydration by drinking 6-10 glasses of water/day to thin the mucus
  • Steamy baths: Inhaled steam (from a hot bath/shower) may loosen secretions
  • If necessary, increase humidity at home
  • Apply warm facial packs (eg warm wash cloth, hot water bottle) for 5-10 minutes ≥3 x/day to promote drainage of mucus and provide some localized relief
  • Adequate rest
  • Avoid irritants that affect sinuses eg cigarette smoke, extreme cool or dry air, pollution, swimming in contaminated water and barotrauma
  • Appropriate management of allergies and viral URTI (eg frequent handwashing)
  • There is little evidence on the efficacy of phytomedical preparations, immunomodulators and bacterial lysate preparations
  • There is no proven benefit to the use of mist, zinc salt lozenges, ascorbic acid, or echinacea
Treatment with Antibiotics
  • Educate the patient about worsening signs and symptoms that should prompt them to contact a physician 
  • It is important to counsel the patient on the use of the medications and its dosing schedule and the potential adverse effects
  • It is important to instruct the patient to complete the course of antibiotics
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Pearl Toh, 19 Jun 2016
Infants with persistent rhinitis have a higher abundance of Actinobacteria, especially Corynebacterium spp., in their nasal microbiome compared with healthy controls, according to a Singapore-based study presented at the European Academy of Allergy and Clinical Immunology (EAACI) Annual Congress 2016 held in Vienna, Austria.
29 Nov 2017
Lansoprazole, a widely available and commonly prescribed proton pump inhibitor (PPI), appears to reduce the incidence of tuberculosis disease, a recent study has found.
Gabriel Angelo Sembrano, 16 Sep 2014

“At present, there is a limited development of new antibiotics. There is also a fast development of resistance to antibiotics. There are pathogens no longer susceptible to all antibiotics, and many pathogens are no longer susceptible to most antibiotics,” said Dr. Andre Villanueva, chief of party of the USAID’s Innovations and Multisectoral Partnerships to Achieve Control of TB (IMPACT) Project at the recent Annual Convention of the Philippine Pharmacists’ Association in Davao City.

Audrey Abella, 06 Jan 2017
Persistent wheeze or childhood asthma may be reduced by fish oil supplementation, particularly n-3 long-chain polyunsaturated fatty acids (LCPUFAs), during pregnancy, a recent Danish study found.