Acute Rhinosinusitis
Drug details
Phenoxymethylpenicillin 500mg four times daily or 1g twice daily
5 days
OR Amoxicillin 1g three times daily
5 days
Penicillin allergy
Doxycycline 200mg stat then 100mg daily
5 days
Very unwell or worsening
Co-amoxiclav 625mg three times daily PLUS amoxicillin 500mg three times daily
5 days
Penicillin Allergy
Seek Advice
Avoid antibiotics as 80% resolve in 14 days without; they only offer marginal benefit after 7 days NNT = 15.
Use adequate analgesia.
Consider 7-day delayed or immediate antibiotic when purulent nasal discharge (NNT = 8). In persistent infection use an agent with anti-anaerobic activity eg. co-amoxiclav.
For glossary of terms see Glossary