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New Sinusitis Treatment Guidelines Unveiled

The condition affects 16 percent of adult Americans, experts say

THURSDAY, Dec. 29, 2005 (HealthDay News) -- Sinusitis is one of the most diagnosed diseases in the United States, affecting approximately 16 percent of adults, and is responsible for nearly $5.8 billion in health-care costs annually.

Updated recommendations for the diagnosis and management of sinusitis have just been released by the American Academy of Allergy, Asthma & Immunology.

The updated practice guidelines include these sinusitis classifications:

  • Acute sinusitis. Symptoms last for less than four weeks and include the following: persistent symptoms of an upper respiratory tract infection, purulent rhinorrhea, postnasal drainage, anosmia, nasal congestion, facial pain, headache, fever, cough and purulent discharge.
  • Subacute sinusitis: symptoms from four to eight weeks.
  • Chronic sinusitis: symptoms for eight weeks or longer of varying severity consisting of the same symptoms as seen in acute sinusitis.
  • Recurrent sinusitis: three or more episodes of acute sinusitis a year.

Diagnosis of sinusitis is based on a combination of clinical history, physical examination, imaging studies, and/or laboratory tests. The updated guidelines recommend:

  • Diagnosis of acute sinusitis should be primarily based on the history and physical examination of the patient. Imaging techniques such as radiographs or CT scans are not necessary.
  • Antibiotics should be withheld for 10 to 14 days, unless the patient develops severe symptoms such as fever, facial pain or tenderness, or swelling around the eye.
  • Antibiotics are the primary therapy for sinusitis. However, with increasing resistance to penicillin being reported, it may be necessary to use alternative antibiotics.
  • Referral to an allergist/immunologist is needed, particularly for people with chronic or recurrent sinusitis associated with certain conditions and for patients who've had prior surgery but still experience sinusitis.
  • Surgery should be considered only after medical therapy has failed.

The guidelines appear in the December issue of the Journal of Allergy & Clinical Immunology.

More information

The American Academy of Family Physicians has more about sinusitis.

SOURCE: Journal of Allergy & Clinical Immunology, news release, December 2005
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