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module menu icon Acute sinusitis

ACUTE SINUSITIS

ELIGIBILITY:1 Adults and children aged 12 years and over

EXCLUDE: Immunosuppressed individuals, chronic sinusitis (causes symptoms that last for more than 12 weeks), pregnant individuals under 16 years

SINUSITIS (sinus infection) is inflammation of the sinuses and nasal cavity. It is usually self-limiting and often triggered by a viral infection such as a cold. In fact, only 2% of cases are caused by a bacterial infection, so antibiotics are rarely used as treatment.1,4,5 There are some signs to help determine if the cause is bacterial and if the customer may be suitable for the Pharmacy First service.

Jason, a 35-year-old male, approaches the counter, asking to purchase another pack of pseudoephedrine tablets for his blocked sinuses. You remember speaking to him about this last week and consider that he may be suffering from sinusitis.

Jason says he is not feeling well. You ask him a few more questions about his symptoms to establish if he is suitable for the Pharmacy First service and to rule out any red flags.

1. SIGNS & SYMPTOMS
2. RED FLAGS

Jason presents with the following signs and symptoms of sinusitis:4

  • Pain, swelling and tenderness around the cheeks, eyes and forehead

  • Blocked nose

  • Runny nose

  • Reduced sense of smell

  • Swollen neck glands (tonsils)

  • Green or yellow mucus from the nose

  • Fever

 

Jason shows all the signs and symptoms of sinusitis; however, it can be difficult to distinguish between viral and acute bacterial sinusitis. The Pharmacy First service is only available for those suffering with bacterial sinusitis. A bacterial cause may be more likely if several of the following symptoms are also present:5

  • Symptoms for more than 10 days

  • Discoloured or purulent (containing pus) nasal discharge

  • Severe, localised one-sided pain (particularly over the teeth and jaw)

  • Fever

  • Worsening over time

Jason does not appear to have any red flag symptoms that would require emergency referral:1,5

  • Reduced vision

  • Swelling over the frontal bone (forehead)

  • Severe headache

  • Reduced consciousness

  • Signs of sepsis

Click the button to find out whether this customer is eligible for referral.

REFERRAL OUTCOME

Referred to the Pharmacy First service

Jason’s sinusitis is likely caused by a bacterial infection, means that he may be eligible for the Pharmacy First service. You explain:

"Purchasing another pack of pseudoephedrine may not be the best option as treatment. Your symptoms suggest that you may have sinusitis which is one of the conditions covered by the Pharmacy First service. Would you like to speak with the pharmacist who can assess this further?"

Jason agrees and the pharmacist completes the consultation which leads to him receiving antibiotic treatment. Think about self-care advice you can provide and products you can recommend that he can use alongside his treatment.

SELF-CARE ADVICE

To help his sinusitis symptoms, you could advise Jason to:4

  • Get plenty of rest

  • Stay hydrated by drinking plenty of fluids

  • Avoid allergens, e.g. pollen or pet dander

  • Don’t smoke

  • As he has a fever and does not feel well, he should stay home and avoid contact with others until his health improves

OTC PRODUCTS

Jason can use some products to help relieve the discomfort of sinusitits:4,5

  • Paracetamol or ibuprofen may be useful to relieve pain and lower his temperature

  • Salt water nasal sprays or solutions can help to clean the inside of the nose

  • Nasal decongestant sprays and drops can be considered to help unblock the nose

To ensure suitability, you should always speak with the pharmacist if the customer is taking any medication (including those provided in the Pharmacy First service) or has any other medical conditions.

Complete the care

Jason tells you that medicated nasal sprays are not suitable for him; however, he will follow the self-care advice and take some paracetamol for the pain. You do not sell Jason the pseudoephedrine tablets that he originally requested, but advise him to come back if he has any other questions or if his symptoms worsen.

KEY LEARNING POINT

If Jason had been sold the medicine he asked for without further questioning, his bacterial infection may have been undetected which could have resulted in his condition worsening. When advising customers, it’s important to consider if Pharmacy First may be a suitable service to determine the best course of action.

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