The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has released updated clinical practice guidelines that highlight areas for improvement and recommendations for clinicians in managing adult sinusitis. 

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The updated guidelines, published in Otolaryngology-Head and Neck Surgery, place a greater emphasis on patient education and patient preference.  New evidence supports a recommendation of either ‘watchful waiting’ or antibiotic therapy for mild, moderate, or even severe acute bacterial sinusitis. Shared decision making was also deemed important when choosing pain relievers, topical intranasal steroids, and nasal saline irrigation for symptomatic relief. 

Updates from the 2007 guideline include:

  • More explicit details about the role of pain relievers, topical intranasal steroids, and/or nasal saline irrigation for symptomatic relief of acute bacterial sinusitis
  • A recommendation of amoxicillin with or without clavulanate when antibiotics are prescribed, while the prior guideline recommended amoxicillin alone
  • Statements about chronic sinusitis, the management of which was not discussed in the 2007 guideline

More than 1 in 5 antibiotics prescribed in adults are for treating sinusitis, making it the fifth most common diagnosis responsible for antibiotic therapy.

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