Acute Rhinosinusitis (Antimicrobial)


Avoid antibiotics as 80% resolve in 14 days without; they only offer marginal benefit after 7 days NNT = 15.

Use adequate analgesia.

Consider 7-day delayed or immediate antibiotic when purulent nasal discharge (NNT = 8). In persistent infection use an agent with anti-anaerobic activity eg co-amoxiclav.

For glossary of terms see Glossary.

Drug details

Phenoxymethylpenicillin 500mg four times daily or 1g twice daily

5 days

OR Amoxicillin 1g three times daily

5 days

Penicillin allergy

Doxycycline 200mg stat then 100mg daily

5 days

Very unwell or worsening

Co-amoxiclav 625mg three times daily PLUS amoxicillin 500mg three times daily

5 days

Penicillin Allergy

Seek Advice

Last reviewed: 25/08/2022

Next review date: 25/08/2025

Author(s): Antimicrobial Management Team.

Version: 2

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Alison Macdonald, Area Antimicrobial Pharmacist.

Document Id: AMT150