Treatment of Acute Exacerbation (Flare) of Chronic Rhinosinusitis
An acute exacerbation of chronic rhinosinusitis is a sudden symptomatic worsening superimposed on underlying chronic sinonasal disease. This clinical scenario calls for a specific treatment approach that differs from routine maintenance management.
Current guidelines recognise acute exacerbations of chronic rhinosinusitis — occurring both with and without nasal polyps — as the specific setting in which antibiotic therapy may be appropriate. Presentations involving fever or severe pain warrant particular clinical attention.
Treatment approach
Management of this exacerbation centres on a defined course of oral antibiotic therapy. The complete regimen, selection criteria, and clinical sequencing are available in the full structured protocol.
References
DOI: 10.1503/cmaj.241101
- Recent guidelines suggest antibiotics should be considered for only acute exacerbations of chronic rhinosinusitis (with and without nasal polyps), while clinicians should remain wary of the patient who presents with fever or severe pain (Table 2).
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