HealthDay News– The Infectious Disease Society of American emphasizes the importance of establishing a clinical diagnosis of bacterial rhinosinusitis before prescribing antibiotics in the first published rhinosinusitis guidelines issued earlier this week.

Only 2% to 10% of acute rhinosinusitis is bacterial, Anthony W. Chow, MD, of the University of British Columbia and Vancouver, Canada, and members of a multidisciplinary panel reported in the March 20 issues of Clinical Infectious Diseases.

Clinical presentation with persistent, severe or worsening symptoms is indicative of acute bacterial rhinosinusitis  rather than viral rhinosinusitis. Antimicrobial therapy should be initiated with a β-lactam agent rather than a respiratory fluoroquinolone. Amoxicillin-clavulanate is recommended instead of amoxicillin alone in children and adults. The recommended duration of therapy is five to seven days for adults and 10 to 14 days for children.

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“This guideline is intended for use by all primary care physicians involved in direct patient care, with particular applicability to patients managed in community or emergency department settings,” the researchers wrote. “Continued monitoring of the epidemiology and rigorous investigation of the efficacy and cost-benefit of empiric antimicrobial therapy for suspected ABRS are urgently needed in both children and adults.”

Several researchers disclosed financial ties to the pharmaceutical industry.

Chow AW et al. Clin Infect Dis. 2012; doi:10.1093/cid/cir1043.