Acute Sinusitis

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Acute Sinusitis

Viruses
Strep. pneumoniae
H. influenzae
M. catarrhalis

Watchful waiting is appropriate in most patients as long as there is follow-up within 7 days or ability to initiate therapy prn if clinical worsening
OR
Amoxicillin 500mg PO q8h

For severe beta-lactam allergy:
Doxycycline 100mg PO BID

Consider treatment only in presence of fever, purulence or bloody discharge following an upper respiratory infection if symptoms persist for 7-10 days suggesting bacterial etiology. 5 days