Sinusitis

• Sinusitis (CKS)

• Rhinitis is often self-limiting but bacterial sinusitis may require treatment with antibacterials.

• Mometasone

• Sodium chloride 0.9% solution may be used as a douche or ‘sniff’ following endonasal surgery.

Sinusitis and oral pain

• Sinusitis affecting the maxillary antrum can cause pain in the upper jaw. Where this is associated with blockage of the opening from the sinus into the nasal cavity, it may be helpful to relieve the congestion with inhalation of warm moist air or with ephedrine hydrochloride nasal drops

• Acute sinusitis is most often viral in origin. Antibacterials should usually be used only for persistent symptoms and purulent discharge lasting at least seven days, or if the symptoms are particularly severe. Current guidance suggests treating with first-line phenoxymethylpenicillin, doxycycline, clarithromycin or erythromycin. Co-amoxiclav is given if there are signs of severe illness or after no improvement with first line antibiotics.

Nasal preparations for infection

• ​There is no evidence that topical anti-infective nasal preparations have any therapeutic value in rhinitis or sinusitis

Resources

• Nose treatment summary (BNF)