Acute Sinusitis
S. pneumoniae, non-typeable H. influenzae, M. catarrhalis
Amoxicillin 90mg/kg/day PO div q12h (max 1000mg/dose)⁵
Unimmunized Patients:
Amoxicillin-Clavulanate† 90mg/kg/day (amox component) PO div q12h (max 1000mg of amox/dose)⁷
Penicillin Allergic Patients (non-severe reaction history):
Cefdinir 14mg/kg/day PO div q12h (max 600mg/dose)
Penicillin Allergic Patients (severe reaction history):
Levofloxacin
6 months to <5 years of age: 20mg/kg/day PO div q12h (max 375 mg/dose);
5 years of age or older: 10mg/kg/day PO div q24h (max 750 mg/dose)⁷
Empiric Therapy & Alternative Regimens
Duration of Therapy & Clinical Pearls
IDSA Guidelines for Acute Sinusitis
Majority of cases are secondary to viral infections, but can consider bacterial source of infection in certain circumstances: Persistent symptoms for ≥ 10 days w/o improvement, persistent high fever of ≥ 39C w/purulent nasal discharge or facial pain ≥3 days, worsening symptoms following initial improvement.⁷
XR or CT is NOT required to make the diagnosis of sinusitis.²
Length of Therapy:
10 days
†For additional information regarding amoxicillin-clavulanate dosing, please see Bugs & Drugs Section.