One Day MD | Evidence-Based Wellness

From NEJM Journal Watch - April 2015 By Kelly Young Edited by Susan Sadoughi, MD , and Richard Saitz, MD, MPH, FACP, FASAM The American Academy of Otolaryngology—Head and Neck Surgery Foundation has updated its 2007 guidelines on managing adult sinusitis. The guidelines, published in Otolaryngology—Head and Neck Surgery , stress shared decision-making between clinicians and patients, particularly in determining whether to try watchful waiting for uncomplicated acute bacterial sinusitis or to prescribe antibiotics right away. Some of the other changes in recommendations include: To relieve the symptoms of acute bacterial rhinosinusitis, clinicians may recommend analgesics, topical intranasal steroids, nasal saline irrigation, or a combination. When antibiotics are prescribed, the recommended first-line treatment is amoxicillin with or without clavulanate for 5–10 days. For chronic rhinosinusitis, clinicians should assess the patient for other chronic conditions (e.g., as...

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