Saturday, December 20, 2014

AAP issues new guidelines for treating sinusitis

How should the sinus inflammation be treated, and how it is different from a cold? Find out here.

AAP issues new guidelines for treating sinusitis

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The American Academy of Pediatrics released its first major revision on the office diagnosis and treatment of sinusitis this week. Sinusitis or inflammation of the sinuses is an infection of the hollow spaces in the bones of the face and head that help us clear our nose and balance.  

Previous guidelines from 2001 recommended antibiotic therapy for all children diagnosed with acute bacterial sinusitis, the new guideline allows doctors to observe children with persistent illness lasting more than 10 days for an additional three days. Children with severe onset or a worsening course of symptoms should receive antibiotics. 

Telling the difference between a common upper respiratory infection (cold) and a sinusitis is not easy. Antibiotics do not make common colds better and they can have serious side effects. Bacterial sinus infections may need antibiotics to stop them from getting worse or causing other serious infections of the head and neck. 

What parents should know about these guidelines is when to go to the doctor because a "cold" may be something more serious.

  1. If the child has a very congested and/or runny nose for 10 days especially when it is associated with a daytime cough (may also have a night cough)
  2. If the child has a high fever (over 39 C, which is 102.2 F) for 72 hours or has a high fever and is not eating or drinking and is difficult to calm
  3. A child's cold got better and then in a day or two the child is suddenly much more ill with a fever and/or pus-filled nasal discharge

Treatment is still basic antibiotics such as amoxicillin or the combination of amoxicillin and clavulinic acid, but at high doses.


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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Mario Cruz, M.D. Pediatrician, Associate Director of Pediatric Residency Program at St. Christopher’s Hospital for Children
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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