Home
Guidelines
Pathogens
Antimicrobials
It is highly discouraged to prescribe antibiotics on the phone without an initial patient encounter and physical examination to confirm the diagnosis and rule out complications
Symptomatic Treatment
PLUS
Amoxicillin/clavulanic acid 875mg/125mg PO BID x 7 days
Better tolerated when taken with food
OR
Doxycycline 100mg PO BID x 7 days
If penicillin allergy or recent amoxicillin use
Reduce the risk of pill-induced esophagitis by drinking enough fluids and avoid taking the evening dose within 2 hours of going to bed
Macrolides
For example:
Use discouraged due to increasing antimicrobial resistance rates among Streptococcus pneumoniae, the most common bacterial etiology of acute sinusitis
Macrolide therapy should be limited to patients with no prior macrolide use within the past 3 months and allergy/intolerance or prior use of both amoxicillin and doxycycline
Fluoroquinolones
According to recent FDA warning, fluoroquinolones should not be used in patients with upper respiratory tract infections, including acute bacterial sinusitis, due to high risk of adverse events
Their use should be reserved for severely immune compromised patients (neutropenia, etc.) or for those who have failed first-line therapy
2nd & 3rd Generation Cephalosporins
Cephalosporin use is not recommended due to high risk of adverse events and induction of antimicrobial resistance
Their use should be limited to patients who have failed first-line options
