Acute Rhinosinusitis

NICE guideline [NG79] Sinusitis (acute): antimicrobial prescribing. Published: Oct 2017. TO BE REVIEWED!

Guidelines

Most patients do not need any specific management apart from symptomatic relief. 
 

Do not offer antibiotics
  • Advise that the usual course of acute sinusitis is 2-3 weeks
  • Paracetamol or ibuprofen for pan or fever
  • Patients may try nasal saline or nasal decongestants but the evidence is not strong 

NICE recommends considering:
  • Antibiotic therapy for 5 days
    • 1st line: phenoxymethylpenicillin
    • Penicillin allergic: clarithromycin / erythromycin (if pregnant)
    • If systemically unwell / features of more serious illness / high risk of complications: Co-amoxiclav
 
  • Intranasal corticosteroids for 14 days
Author: Adams Lau
Reviewer: 
Last edited: 25/04/25