Management of acute bacterial rhinosinusitis

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Published on: January 17, 2018

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
PubMed

Insights

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.

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