Sinusitis

Choosing Wisely Canada Recommendation

Don’t prescribe antibiotics unless symptoms have persisted for greater than 7-10 days without improvement.

Differentiating viral rhinosinusitis (VRS) from acute bacterial rhinosinusitis (ABRS) can be challenging. Patients not meeting the below criteria are best managed with a viral prescription.

Antibiotics should only be considered if the patient has at least 2 of the below PODS symptoms, one of those being O or D, AND the patient meets one of the following criteria:

1) The symptoms are severe
2) The symptoms are mild to moderate, if there is no response after a 72 hours trial with nasal corticosteroids.

P: Facial pain/pressure/fullness
O: Nasal obstruction
D: Purulent/discolored nasal or postnasal discharge
S: Hyposmia/anosmia

Duration of Therapy

Shorter duration antimicrobial therapy may be appropriate in some cases