Gordon H. Sun, MD, MS

April 29, 2014

Sinusitis: A Plethora of Guidelines

There is general agreement that for children without penicillin allergy, both amoxicillin and amoxicillin/clavulanate are reasonable first-line options. The Infectious Diseases Society of America (IDSA) 2012 guideline recommends amoxicillin/clavulanate for children and adults with ABRS, although no prior studies were cited to support their recommendation.[2] The AAP 2013 guideline for children with ABRS recommends either amoxicillin or amoxicillin/clavulanate.[3] The guidelines disagree on the value of adjunctive therapies, such as intranasal steroids or nasal saline irrigation.

The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 2007 clinical practice guideline recommends amoxicillin for adults, owing to its safety, efficacy, low cost, and narrow-spectrum antibacterial activity.[4] The guideline cites a systematic review and 2 randomized controlled trials demonstrating no significant difference in the rates of clinical resolution of patients with ABRS treated with amoxicillin or amoxicillin/clavulanate compared with those treated with cephalosporins or macrolides.

What About Patients With Penicillin Allergy?


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