Updated Adult Sinusitis Guidelines Released

The American Academy of Otolaryngology—Head and Neck Surgery Foundation has released updates to its 2007 guidelines on the management of adult sinusitis.

The update comes in response to new data from 5 clinical practice guidelines, 42 systematic reviews, and 70 randomized, controlled trials.
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“The goals [of  the updated guideline] are to improve diagnostic accuracy for adult rhinosinusitis, promote judicious use of systemic and topical therapy, and promote appropriate use of ancillary tests to confirm diagnosis and guide management, including radiography, nasal endoscopy, computed tomography, and testing for allergy and immune function.”

Specific changes to the guideline include:

• The extension of watchful waiting without antibiotic therapy as the initial management strategy for patients with acute bacterial rhinosinusitis.

• Recommending amoxicillin with or without clavulante for 5-10 days as the first-line recommended treatment for patients with acute bacterial rhinosinusitis.

• Addition of asthma to the list of chronic conditions that modify management of chronic rhinosinusitis.

• New action statements managing chronic rhinosinusitis focusing on polyps, the use of topical intranasal therapy, and a recommendation against the use of topical or systemic antifungal agents.

—Michael Potts

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): Adult sinusitis. Otolaryngol Head Neck Surg.2015;52(4):598-609.