The American Academy of Pediatrics has issued “Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years” for physicians diagnosing acute bacterial sinusitis in children to determine when antibiotic treatment is necessary.

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These guidelines, published in the July 2013 Pediatrics (published online June 24, 2013), are based on the analysis of the medical literature since the 2001 AAP guidelines.

In general, acute bacterial sinusitis can be diagnosed when a child with an acute upper respiratory infection has symptoms lasting > 10 days, or a severe onset of symptoms including fever and nasal discharge lasting >3 days in a row.


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Regarding antibiotic therapy initiation, the 2001 guidelines recommended therapy for all children diagnosed with acute bacterial sinusitis. However, the 2013 guidelines permits physicians to observe children with persistent illness lasting >10 days for an additional 3 days. Those with severe onset or worsening symptoms are recommended to receive antibiotics. Amoxicillin, listed as first-line treatment, may be switched to another antibiotic if symptoms worsen or do not improve after 72 hours.

Further review of the evidence also indicates that imaging tests are not necessary in children with uncomplicated acute bacterial sinusitis, and are not recommended by the AAP.

For more information call (847) 434-7877 or visit AAP.org.