Management update of acute bacterial rhinosinusitis and the use of cefdinir.

Author(s): Gwaltney JM Jr

Affiliation(s): Department of Internal Medicine, University of Virginia Health System, Charlottesville, 22908, USA. jmg3u@virginia.edu

Publication date & source: 2002-12, Otolaryngol Head Neck Surg., 127(6 Suppl):S24-9.

Publication type:

The pathogenesis, bacteriology, diagnosis, and antimicrobial treatment of acute bacterial rhinosinusitis (ABRS) is reviewed. Most cases of ABRS arise as complications of the rhinosinusitis of colds and other acute viral respiratory infections. Nose blowing during colds may be a risk factor for ABRS by propelling bacteria-laden nasal fluid into the sinus cavity. The bacterial causes of ABRS continue to be S pneumoniae. H influenzae, other streptococcal species, M catarrhalis, anaerobes, and S aureus. Clinical diagnosis of ABRS is based on obtaining a history of a cold or influenza-like illness that is no better or worse after >/=7 days. A 10-day course of treatment with an antimicrobial effective against resistant S pneumoniae and H influenzae is recommended. A clinical trial was reviewed in which cefdinir was effective in treating ABRS.