AAO-HNS Releases Multispeciality Practice Guidelines for Adult Rhinosinusitis

Observation Option

Dr. Rosenfeld told the audience that some physicians might be reluctant to use the observation option for acute bacterial rhinosinusitis because they (as well as their patients) believe that bacterial illnesses should be treated with antibiotics. These barriers can be overcome with educational pamphlets and information sheets that outline the favorable natural history of nonsevere bacterial rhinosinusitis, the moderate incremental benefit of antibiotics on clinical outcomes, and the potential adverse effects of orally administered antibiotics, especially induced bacterial resistance.

He added that some patients and clinicians might object to amoxicillin as first-line therapy and cited the well-known false belief that newer and more expensive antibiotics are necessarily more effective. However, randomized trials do not support the benefit of one antibiotic over another for initial empirical treatment.

©2007 The Triological Society