Clinical practice guideline (update): adult sinusitis

Area of Science:

• Otolaryngology
• Evidence-based medicine
• Clinical practice guidelines

Background:

• Rhinosinusitis, inflammation of the sinuses and nasal cavity, affects adults.
• Previous guidelines for adult rhinosinusitis management were published in 2007.
• This update incorporates new systematic reviews and patient perspectives.

Purpose of the Study:

• To provide evidence-based recommendations for managing adult rhinosinusitis.
• To improve diagnostic accuracy and guide appropriate therapy selection.
• To identify chronic conditions that modify rhinosinusitis management.

Main Methods:

• Multidisciplinary guideline development.
• Inclusion of 42 new systematic reviews.
• Development of an updated algorithm for clinical decision-making.

Main Results:

• Strong recommendations to differentiate acute bacterial rhinosinusitis (ABRS) from viral infections and confirm chronic rhinosinusitis (CRS) with objective data.
• Recommendations for ABRS include watchful waiting or antibiotics (amoxicillin/clavulanate first-line).
• For CRS, recommendations include saline nasal irrigation, intranasal corticosteroids, and assessment for comorbidities like asthma.

Conclusions:

• Updated clinical practice guidelines for adult rhinosinusitis management.
• Emphasis on accurate diagnosis and judicious use of therapies.
• Integration of patient education and management of comorbid conditions.