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Most cases of acute sinusitis take two to three weeks to resolve and do not need treatment with antibiotics – many patients will be unaware of this
Most cases are caused by viruses. Only two in 100 cases will be complicated by bacterial infection
NICE advises that even bacterial sinusitis is usually self-limiting and does not routinely need antibiotics
Self-care measures include analgesics and nasal saline irrigation
Symptoms indicating bacterial infection are a marked deterioration after an initial milder phase, fever (above 38°C), unremitting purulent nasal discharge and severe unilateral pain (especially tooth and/or jaw pain)
A high-dose nasal corticosteroid, supplied via a PGD for 14 days (off-label), can be recommended for those who have had persistent unremitting symptoms for 10 days or longer
Antibiotics can be provided via a PGD where there are still persistent symptoms despite the use of high-dose nasal corticosteroid for 14 days or if high-dose nasal corticosteroids are unsuitable.
Key facts