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See discussions, stats, and author profiles for this publication at:Acute Bacterial Sinusitis in Adults: Management in the Primary Care SettingArticleinThe Journal of otolaryngology · November 2002DOI: 10.2310/7070.2002.1161 · Source: PubMedCITATIONS36READS1,97715 authors, including:Some of the authors of this publication are also working on these related projects:proinflammatory cytokines and asthmaView projectBronchial Smooth Muscle Contractile Proteins in AsthmaView projectMartin DesrosiersCentre hospitalier de l'Université de Montréal (CHUM)233PUBLICATIONS6,869CITATIONSSEE PROFILEQutayba HamidUniversity of Sharjah813PUBLICATIONS59,415CITATIONSSEE PROFILEStuart CarrUniversity of Alberta28PUBLICATIONS731CITATIONSSEE PROFILEMichael HawkeUniversity of Toronto173PUBLICATIONS2,511CITATIONSSEE PROFILEAll content following this page was uploaded byMartin Desrosierson 01 June 2014.The user has requested enhancement of the downloaded file.
The Journal of Otolaryngology, Volume 31, Supplement Number 2, October 20022S2Acute sinusitis is one of the most common condi-tions treated in the outpatient setting in NorthAmerica and is thought to affect everyone at least oncein their lifetime.1–4Sinus disease, that is, inflammation and/or mucosalthickening, is inherently associated with viral upperrespiratory tract infections and occurs in 90% of indi-viduals with the common cold, although the vastmajority are viral and not considered clinically rele-vant.4–10Acute bacterial infections occur in 0.5 to 2%of these individuals, of which 90% is localized to orincludes the maxillary sinus.4,10,11Adults average twoto three colds per year and children six to eight peryear; thus, the absolute number of people who mayAcute Bacterial Sinusitis in Adults:Management in the Primary Care SettingMartin Desrosiers, MD, FRCSC, Saul Frenkiel, MD, FRCSC,Qutayba A. Hamid, MD, PhD, Don Low, MD, Peter Small, MD, FRCPC,Stuart Carr, MD, FRCPC, Michael Hawke, MD, FRCPC,David Kirkpatrick, MD, FRCSC, François Lavigne, MD, FRCSC,Lionel Mandell, MD, FRCSC, Holly E. Stevens, MD, FRCSC,Karl Weiss, MD, FRCPC, Ian J. Witterick, MD, FRCSC,Erin D. Wright, MD, FRCSC, and Ross Davidson, PhDAbstractSinus disease is inherently associated with viral upper respiratory tract infections and occurs in 90% of individuals with thecommon cold. Acute bacterial sinusitis occurs in 0.5 to 2% of these individuals. Although the diagnosis of acute bacterialsinusitis is usually based on physical findings, no one sign or symptom is either sensitive or specific for sinusitis. The predic-tive power can be significantly improved when all signs and symptoms are combined into a clinical impression. Imagingstudies have not been shown to be cost effective in the initial assessment and treatment of patients in the primary care set-ting. Simple plain films may be indicated to resolve the diagnosis in patients with an equivocal history or to follow patientsadmitted to hospital with severe sinus disease. The initial management of acute sinusitis should be directed toward the reliefof symptoms with a 7-day course of decongestants and mucoevacuents. For patients who fail to improve with symptomatictreatment, a 10-day course of amoxicillin is recommended. Second line antibiotics should be initiated if improvement is notseen within 72 to 96 hours.

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Term
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Sinusitis, Chronic sinusitis

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