Acute Bacterial Sinusitis

Acute bacterial sinusitis complicates colds in both adults and children. From a 1% to 5% of colds have this complication. (46-47)

The major causes of the acute bacterial sinusitis are the bacteria called pneumococcus, Hemophilus influenza, Moraxella, other Streptococcus species, and Staphylococcus. (48) Bacterial sinusitis also complicates tooth root infection, in which case it is caused by anaerobic bacteria.

When a common cold has lasted for 7-10 days and is no better or worse, acute bacterial sinusitis may have developed and additional medical care may be required. (48)

Acute bacterial sinusitis requires antibiotic treatment to reduce the duration of infection and illness and to prevent serious complications such as infection around the eye, bacterial meningitis, and brain abscess. (49) Chronic sinus disease is thought to be another complication of untreated or inadequately treated acute bacterial sinusitis.

The antibiotic treatment selected for acute sinusitis should be effective against most strains of pneumococcus and hemophilus. (45) The recommended course of antibody treatment for acute bacterial sinusitis is 10-14 days.

With proper antibiotic treatment, over 90% of cases of acute bacterial sinusitis are cured. (50)

The possible benefit of using steroid nasal sprays for treating acute bacterial sinusitis has not been adequately studied. This treatment is not recommended because of its additional costs to the treatment program and because antibiotic treatment alone is highly effective.

Nasal and oral decongestants are commonly used for supportive treatment of acute bacterial sinusitis. The benefit of decongestant treatment for this disease has not been studied, but decongestants open the areas in the nasal passages into which the sinuses drain. (48) Decongestants do not open the passages which drain the sinus itself because these small passages are encased in bone (see Understanding Colds - Anatomy).

Cases of acute bacterial sinusitis which do not respond to an initial course of antibiotics should receive a second course of antibiotic treatment. (48) Also, a sinus puncture and irrigation should be considered for diagnosis and treatment.

Cases of acute bacterial sinusitis that do not clear after a few months of appropriate medical treatment may require sinus surgery. (48)



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