COMMENTARY

Diagnosing and Treating Rhinosinusitis: New Guidelines

Anthony W. Chow, MD

Disclosures

April 05, 2012

In This Article

New Guidelines for Rhinosinusitis Now Available

The Infectious Diseases Society of America has published its first-ever recommendations for the diagnosis and management of acute bacterial rhinosinusitis (ABRS) infections.[1] The guidelines used the new GRADE system (Grading of Recommendations Assessment, Development and Evaluation), which is designed to more clearly assess the quality of evidence and report the strength of recommendations. The ABRS guidelines were posted online March 21, 2012, and will appear in the April 15, 2012, issue of Clinical Infectious Diseases.

Because the infection causes inflammation of both the sinuses and the nasal cavity, the ABRS guidelines use the term "rhinosinusitis" instead of the more common "sinusitis." The purpose of the guidelines is to provide clarity and guidance to physicians and other primary care providers in diagnosing and treating the infection. The guidelines specifically address the following:

  • The inability of existing clinical criteria to accurately differentiate bacterial from viral acute rhinosinusitis, leading to excessive and inappropriate antimicrobial therapy;

  • Gaps in knowledge and quality evidence about empiric antimicrobial therapy for ABRS as a result of imprecise patient selection criteria;

  • Changing prevalence and antimicrobial susceptibility profiles of bacterial isolates associated with ABRS; and

  • The effect of conjugated vaccines for Streptococcus pneumoniae on the emergence of nonvaccine serotypes associated with ABRS.

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