Antibacterial management of acute and chronic sinusitis

Sinusitis is a common disorder in both children and adults. It is responsible for significant absenteeism from school and work. Up to 10% of upper respiratory infections in children are complicated by acute sinusitis. Since antibacterial therapy is most often empirically chosen to treat the disorder, knowledge of the typical etiologic agents as well as awareness of the antibacterial susceptibility profiles in a given community are of paramount importance. The need for consistently bactericidal antibacterials, the recognition of the importance of nontypable Hemophilus influenzae unresponsive to first-generation cephalosporins, tetracyline-resistant Gram-positive cocci, and the increasing emergence of beta-lactamase-positive respiratory pathogens such as H. influenzae and Moraxella catarrhalis, now mandate the use of newer therapeutic agents for acute and chronic sinusitis.