Acute bacterial sinusitis in children.

Abstract

On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

• Authors: Gregory DeMuri, Ellen R Wald
• Journal: Pediatrics in review (Pediatr Rev) Vol. 34 Issue 10 Pg. 429-37; quiz 437 (Oct 2013) ISSN: 1526-3347 [Electronic] United States
• PMID: 24085791 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Bacterial Agents
• Amoxicillin-Potassium Clavulanate Combination

Topics

• Acute Disease
• Amoxicillin-Potassium Clavulanate Combination (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (diagnosis, drug therapy)
• Child
• Diagnosis, Differential
• Humans
• Respiratory Tract Infections (diagnosis)
• Sinusitis (diagnosis, drug therapy, microbiology)
• Virus Diseases (diagnosis)