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Adult sinusitis: Updated clinical practice guideline

Date:
April 1, 2015
Source:
American Academy of Otolaryngology - Head and Neck Surgery
Summary:
Sinusitis affects about one in eight adults in the United States, resulting in over 30 million annual diagnoses. The direct cost of managing acute and chronic sinusitis exceeds $11 billion per year. More than one in five antibiotics prescribed in adults are for sinusitis, making it the fifth most common diagnosis responsible for antibiotic therapy.
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An updated clinical practice guideline from the American Academy of Otolaryngology--Head and Neck Surgery Foundation published in Otolaryngology-Head and Neck Surgery identifies quality improvement opportunities and explicit actionable recommendations for clinicians managing adult sinusitis, including a greater focus on patient education and patient preference.

"More than ever before, there is a prominent role for shared decision-making between patients and clinicians when managing adult sinusitis--especially in deciding whether to use antibiotics for acute bacterial sinusitis or to instead try 'watchful waiting' to see if a patient can fight the infection on his or her own," explained Richard M. Rosenfeld, MD, MPH, who chaired both the 2007 guideline and the 2015 update.

"Intuitively clinicians often feel that sicker patients benefit more from antibiotics, but our recommendation is that watchful waiting or antibiotics are both appropriate. This empowers patients and clinicians to use antibiotic judiciously, reserving antibiotics for cases that get worse or don't improve over time."

Those shared decisions also are important regarding sinusitis symptom relief options such as pain relievers, topical intranasal steroids, and nasal saline irrigation.

Other differences between the 2007 guideline and the 2015 update include:

  • more explicit details about the role of pain relievers, topical intranasal steroids, and/or nasal saline irrigation for symptomatic relief of acute bacterial sinusitis;
  • a recommendation of amoxicillin with or without clavulanate when antibiotics are prescribed, while the prior guideline recommended amoxicillin alone;
  • several statements about chronic sinusitis, the management of which was not discussed in the 2007 guideline.

This evidence-based clinical guideline for adult sinusitis was updated by a multi-disciplinary panel of experts in otolaryngology-head and neck surgery, infectious disease, family medicine, allergy and immunology, advanced practice nursing, and a consumer advocate.


Story Source:

Materials provided by American Academy of Otolaryngology - Head and Neck Surgery. Note: Content may be edited for style and length.


Journal Reference:

  1. R. M. Rosenfeld, J. F. Piccirillo, S. S. Chandrasekhar, I. Brook, K. Ashok Kumar, M. Kramper, R. R. Orlandi, J. N. Palmer, Z. M. Patel, A. Peters, S. A. Walsh, M. D. Corrigan. Clinical Practice Guideline (Update): Adult Sinusitis. Otolaryngology -- Head and Neck Surgery, 2015; 152 (2 Suppl): S1 DOI: 10.1177/0194599815572097

Cite This Page:

American Academy of Otolaryngology - Head and Neck Surgery. "Adult sinusitis: Updated clinical practice guideline." ScienceDaily. ScienceDaily, 1 April 2015. <www.sciencedaily.com/releases/2015/04/150401145439.htm>.
American Academy of Otolaryngology - Head and Neck Surgery. (2015, April 1). Adult sinusitis: Updated clinical practice guideline. ScienceDaily. Retrieved May 27, 2017 from www.sciencedaily.com/releases/2015/04/150401145439.htm
American Academy of Otolaryngology - Head and Neck Surgery. "Adult sinusitis: Updated clinical practice guideline." ScienceDaily. www.sciencedaily.com/releases/2015/04/150401145439.htm (accessed May 27, 2017).

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