التهاب الجيوب الأنفية البكتيري الحاد غير المعقد مع فرط الحساسية من غير النوع 1 للبنسلين — عندما لم يُحسّن العلاج من الخط الأول الأعراض

DOI: 10.1002/ohn.1344

• A clinician should diagnose ABRS when (a) symptoms or signs of acute rhinosinusitis (purulent nasal drainage accompanied by nasal obstruction, facial pain-pressure-fullness, or both) persist without evidence of improvement for at least 10 days beyond the onset of upper respiratory symptoms, or (b) symptoms or signs of acute rhinosinusitis worsen within 10 days after an initial improvement (double worsening).
• For patients with non-type 1 penicillin hypersensitivity, either doxycycline or a third-generation oral cephalosporin (cefixime 400 mg PO od or cefpodoxime 200 mg PO bid) with or without clindamycin (450 mg PO tid) is recommended.
• Respiratory fluoroquinolone (levofloxacin 500 mg or 750 mg PO od or moxifloxacin 400 mg PO od) is another alternative, but this antibiotic regimen should be reserved for those who have no alternative treatment options for reasons noted above.