Management of acute rhinosinusitis in children

Acute rhinosinusitis (ARS) is a common condition in children, usually preceded by a viral upper respiratory tract infection (URTI). Diagnosing ARS can be challenging, relying primarily on clinical history and examination. Differentiating between viral URTI, post-viral ARS and acute bacterial rhinosinusitis (ABRS) is crucial for guiding appropriate antibiotic treatment. Antibiotics have been showed to be effective in improving symptom scores and cure rates in ABRS. Adjunct therapies, including corticosteroids, nasal saline irrigation and analgesics, may provide symptomatic relief. While viral ARS is self-limiting, bacterial ARS can lead to severe complications, including orbital and intracranial involvement, necessitating timely diagnosis and treatment. This review highlights current evidence on the diagnosis and management of ARS in children, emphasising best practices to optimise patient outcomes and prevent complications.