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Management of acute bacterial rhinosinusitis
Dennis A Conrad1, Hal B Jenson
1Department of Pediatrics, Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA. conradd@uthscsa.edu
Current Opinion in Pediatrics
|March 7, 2002
Summary
Acute bacterial rhinosinusitis in children is diagnosed clinically based on specific symptoms like persistent cough and purulent nasal discharge. High-dose amoxicillin is the recommended initial treatment for this common sinus infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Otolaryngology
Background:
- Acute bacterial rhinosinusitis (ABRS) affects the nasal epithelium and paranasal sinus mucosa in children.
- Common causative agents include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Purpose of the Study:
- To outline the clinical diagnosis and management of acute bacterial rhinosinusitis in pediatric patients.
- To emphasize appropriate initial pharmacotherapy and treatment duration.
Main Methods:
- Clinical diagnosis based on characteristic symptoms such as prolonged cough and purulent rhinorrhea.
- Radiographic evaluation is generally not indicated for diagnosis.
- CT scans are reserved for persistent or complicated cases.
Main Results:
- Diagnosis relies on symptoms lasting at least 10 days, often with worsening after initial cold symptoms.
- Facial pain, headache, and fever can also be present.
- Complications of ABRS in children are infrequent.
Conclusions:
- High-dose amoxicillin (80-90 mg/kg/day) is the recommended first-line therapy.
- Treatment duration is typically 10-14 days, continuing for 7 days post-symptom improvement.
- Prompt and appropriate treatment is crucial for managing pediatric ABRS.