Sinusitis

NHSL Antimicrobial Guidelines
NHS Lanarkshire

Advise paracetamol or ibuprofen for pain. Little evidence that nasal saline or nasal decongestants help, but people may want to try them.

Symptoms for 10 days or less: no antibiotic.

Symptoms with no improvement for more than 10 days: no antibiotic or back-up antibiotic depending on likelihood of bacterial cause. Consider high-dose nasal corticosteroid (if over 12 years).

Systemically very unwell or high risk of complications: immediate antibiotic.

Drug details

Drug

First choice:

Amoxicillin

Dosage

500mg

Duration

3 times a day 5 days

Child Dose

Drug

Penicillin allergy or alternative required:

Doxycycline

Dosage

200mg

Duration

on day 1 then 100mg once daily for 4 further days.

Use clarithromycin for 5 days in children under 12 with penicillin allergy.

Child Dose

Drug

OR (penicillin allergy in pregnancy)

Erythromycin

Dosage

250-500mg

Duration

4 times a day or 500-1000mg twice daily 5 days.

 

For persistent symptoms seek advice from ENT.

Editorial Information

Last reviewed: 18/05/2022

Next review date: 18/05/2025

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick, Heather Boyle.

Version: V1

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.

Document Id: June 2022