Chapter 128. Pneumococcal Infections (Part 8)
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Acute Sinusitis Just as the pathogenesis and microbial etiology of acute rhinosinusitis are similar to those of otitis media, so are the principles of diagnosis and treatment. The diagnosis is often empirical, and the less rigorously it is made, the more irrelevant antibiotics are likely to be. The estimated efficacy rate for amoxicillin/clavulanic acid, fluoroquinolones, and ceftriaxone (available for parenteral use only) is 90–92%, as opposed to 83–88% for amoxicillin, trimethoprim-sulfamethoxazole, and oral secondor third-generation cephalosporins and 71–81% for macrolides and doxycycline. Treatment should be given for longer periods than are recommended for otitis media (perhaps 10–14 days), but the...
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