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Acute Rhinosinusitis


It is the inflammation of the mucosal lining of the nose and paranasal sinuses of not more than 12 weeks duration. In sinusitis of dental origin, anaerobic bacteria are often found. 

Acute Purulent Rhinosinusitis 


Bacterial infection with pus accumulation in one or more of the paranasal sinuses 

Diagnostic Criteria

  • Anterior rhinoscopy – watery/purulent nasal discharge occasionally foul smelling

  • Nasal congestion

  • Plain paranasal sinuses X ray (Water’s, Caldwell views) 

  • Mucosal thickening; air fluid levels 

Pharmacological Treatment:  


  • Phenoxymethylpenicillin (PO) 500mg 8 hourly for 7 days. Children up to 5 years: 6 mg/kg 6 hourly for 10 days    



  • Azithromycin (PO) 500mg once daily for 3 days. Children: 10mg/kg once daily for 3 days     


  • Amoxicillin+Clavulanic acid (PO) Adults: 625mg (500mg amoxicillin+125mg Clavulanic acid) 8 hourly for 7 days  Children: 375mg (250mg amoxicillin,+125 Clavulanic acid) 12 hourly for 7 days;    

Note: Treatment periods shorter than ten days increase the risk of treatment failure 

Referral: To ENT Specialists  

  • Children with ethmoiditis presenting as an acute periorbital inflammation or orbital cellulitis must be hospitalized immediately

  • Adults with pronounced symptoms despite treatment 

  • If sinusitis of dental origin is suspected

  • Recurrent sinusitis (>3 attacks in a year) or chronic sinusitis (duration of illness of >12 weeks)

Updated on, 31.10.2020


1. STG 

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