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Key facts

  • Most cases of acute sinusitis take two to three weeks to resolve and do not need treatment with antibiotics – many patients will be unaware of this
  • Most cases are caused by viruses. Only two in 100 cases will be complicated by bacterial infection
  • NICE advises that even bacterial sinusitis is usually self-limiting and does not routinely need antibiotics
  • Self-care measures include analgesics and nasal saline irrigation
  • Symptoms indicating bacterial infection are a marked deterioration after an initial milder phase, fever (above 38°C), unremitting purulent nasal discharge and severe unilateral pain (especially tooth and/or jaw pain)
  • A high-dose nasal corticosteroid, supplied via a PGD for 14 days (off-label), can be recommended for those who have had persistent unremitting symptoms for 10 days or longer
  • Antibiotics can be provided via a PGD where there are still persistent symptoms despite the use of high-dose nasal corticosteroid for 14 days or if high-dose nasal corticosteroids are unsuitable.
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