Acute sinusitis in adults. Difficult to diagnose, essential to treat

Acute sinusitis is difficult to diagnose. Diagnosis depends on obtaining a complete history and physical examination in addition to use of radiographic diagnostic aids and, if necessary, sinus aspiration. Once the diagnosis is made, empirical treatment with antibiotic agents and adjunctive measures should be started. Because most acute sinus infections are caused by H influenzae and S pneumoniae, the preferred antibiotic for treatment is amoxicillin or TMP-SMZ. Timely and appropriate therapy prevents complications. Symptoms persisting after completion of an appropriate course of treatment are an indication for referral to an otolaryngologist.