AAP issues new guidelines for treating sinusitis

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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