Acute Uncomplicated Bacterial Rhinosinusitis (ABRS)
Clinical Pearls

Clinical Pearls

Clinical Pearls

  • Watchful waiting should be excluded in patients with immune deficiency or coexisting bacterial illness
  • Prescribers should also consider the patient’s age, general health, cardiopulmonary status and comorbid conditions when assessing suitability for watchful waiting

Macrolides are not recommended for empiric therapy due to growing resistance rates for Streptococcus pneumoniae and Haemophilus influenzae within New Brunswick

  • Respiratory fluoroquinolones (e.g. levoFLOXacin, moxifloxacin) should be reserved for failure of first-line options due to the potential for increasing resistance, risk of C. difficile infection and their importance in the management of other infections
  • Respiratory fluoroquinolones (e.g. levoFLOXacin, moxifloxacin) have not been found to be superior to β-lactams in the management of ABRS

Antibiotics have not been shown to be beneficial in chronic rhinosinusitis without acute clinical deterioration

Consider ID consultation for refractory nosocomial rhinosinusitis or if immunocompromised

Decongestants (topical or oral) and/or antihistamines are not recommended as adjunctive therapy