Acute Rhinosinusitis

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

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

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Last reviewed: 25 August 2022

Next review: 25 August 2025

Author(s): Antimicrobial Management Team

Version: 2

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT150