Treatment modalities for bacterial rhinosinusitis.
BACKGROUND
Rhinosinusitis is a common illness that represents a substantial economic burden. The vast majority of cases resolve spontaneously but a small proportion develops a secondary bacterial infection. Accurate diagnosis of rhinosinusitis depends upon clinical assessment. Isolation of the causative agents must be considered in cases failing initial treatment.


METHODS
This up-to-date review defines the anatomy, pathogenesis, phases of rhinosinusitis, the unique microbiology of each type of rhinosnusitis (acute and chronic, acute exacerbation, nosocomial, rhinosinusitis in immunocompromised host, and rhinosinusitis of ododental origin), clinical features, diagnosis, and treatment.


RESULTS
The reader will gain understanding of the above issues and logic for choosing the appropriate treatment for each condition of rhinosinusitis.


CONCLUSIONS
The proper choice of antibiotic therapy depends on the probable infecting pathogens, bacterial antibiotic resistance and antibiotics' pharmacologic profiles. In addition to antibiotics, adjuvant therapies and surgery are used in the management of bacterial sinusitis. Accurate diagnosis and careful consideration when choosing therapy for rhinosinusitis will optimize the chances of achieving an early recovery and avoiding complications.
Brook
Itzhak
I
Department of Pediatrics and Medicine, Georgetown University School of Medicine, Washington, DC 20016, USA. ib6@georgetown.edu
D000208:Acute Disease; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000382:microbiology; D002908:Chronic Disease; D017281:Cost of Illness; D006801:Humans; D016867:Immunocompromised Host; D012220:Rhinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D012852:Sinusitis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents