What are the guideline sources, guidelines and references for Acute bacterial rhinosinusitis ?
Guideline sources The following summarized guidelines for the evaluation and management of acute bacterial rhinosinusitis (ABRS) are prepared by our editorial team based on guidelines from the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF 2015; 2013) and the Infectious Diseases Society of America (IDSA 2012). 1 2 3 4 4 4 5 Definition ABRS, also known as acute sinusitis, is an inflammation of the nasal cavity and paranasal sinuses that lasts up to 4 weeks. 4 Epidemiology ABRS is mostly caused by S. pneumoniae, Haemophilus influenza, and Moraxella catarrhalis. 4 Disease course Nasal and paranasal infection results in ABRS, which causes clinical manifestations of nasal congestion and obstruction, purulent nasal discharge, facial pain or pressure, fever, fatigue, cough, hyposmia, ear pressure, headache, and halitosis. Disease progression may result in orbital and CNS complications. 4 Prognosis and risk of recurrence https://web.pathway.md/diseases/recWH9VnX7b3GYOHL 1/5 6/23/23, 1:37 AM Acute bacterial rhinosinusitis Pathway ABRS with ocular complications is associated with a 3.17% mortality rate. 5 Calculator Clinical criteria for acute bacteri Guidelines 1. Screening and diagnosis Diagnostic criteria: As per AAO-HNSF 2015 guidelines, diagnose ABRS in patients with: symptoms or signs of acute rhinosinusitis that persist for 10 days after the onset of symptoms, without evidence of improvement symptoms or signs of acute rhinosinusitis that worsen after an initial improvement, within 10 days of the onset of symptoms. B As per IDSA 2012 guidelines, diagnose ABRS in patients with: symptoms or signs of acute rhinosinusitis that persist for 10 days, without any evidence of improvement symptoms or signs of acute rhinosinusitis that worsen, after initial improvement of symptoms of a typical viral upper respiratory infection that lasted 5-6 days, with new onset of fever, headache, or increase in nasal discharge severe symptoms or signs of acute rhinosinusitis, with high fever ( 39 C or 102 F) and purulent nasal discharge or facial pain, lasting for at least 3-4 consecutive days at the beginning of illness. B 2. Diagnostic investigations Diagnostic imaging: As per AAO-HNSF 2015 guidelines, avoid obtaining diagnostic imaging in patients who meet clinical criteria for acute rhinosinusitis, unless a complication or alternative diagnosis is suspected. D As per IDSA 2013 guidelines, avoid obtaining diagnostic imaging (such as sinus X-ray, contrast- enhanced CT, MRI, or ultrasound) to distinguish acute bacterial sinusitis from viral upper respiratory infection. D Sinus cultures: as per IDSA 2012 guidelines, avoid obtaining nasopharyngeal cultures in patients with ABRS. D Show 2 more https://web.pathway.md/diseases/recWH9VnX7b3GYOHL 2/5 6/23/23, 1:37 AM Acute bacterial rhinosinusitis Pathway Evaluation of recurrent acute rhinosinusitis: as per AAO-HNSF 2015 guidelines, assess patients with recurrent acute rhinosinusitis for chronic conditions that would modify management, such as asthma, cystic fibrosis, immunodeficiency, and ciliary dyskinesia. B 3. Medical management Symptomatic treatment: As per AAO-HNSF 2015 guidelines, consider using analgesics, topical intranasal steroids, and/or intranasal saline irrigation for symptomatic relief in patients with ABRS. C As per IDSA 2012 guidelines, advise intranasal saline irrigation (with either physiologic or hypertonic saline) as an adjunctive treatment in adult patients with ABRS. B Show 2 more Antibiotic therapy: As per AAO-HNSF 2015 guidelines: Offer either watchful waiting or antibiotic therapy for adults with uncomplicated ABRS. Watchful waiting should be offered only when adequate follow-up can be ensured, such that antibiotic therapy is started if the patient fails to improve within 7 days, or worsens at any time. B Administer amoxicillin (with or without clavulanate) as first-line antibiotic therapy in most adult patients with ABRS, and complete 5-10 days of treatment. B As per IDSA 2012 guidelines, initiate antibiotic therapy in patients in whom a clinical diagnosis of ABRS is established, as defined by IDSA criteria. B Show 2 more 4. Follow-up and surveillance Indications for specialist referral: Obtain specialist consultation with an otolaryngologist, infectious disease specialist, or allergist in the following situations: patients who are seriously ill and immunocompromised patients who continue to deteriorate clinically despite extended courses of antimicrobial therapy patients who have recurrent bouts of acute rhinosinusitis with clearing between episodes. B Management of nonresponse to treatment: As per AAO-HNSF 2015 guidelines, reassess initial management in patients who worsen or fail to improve within 7 days of diagnosis, in order to confirm the diagnosis, exclude other causes of illness, and detect potential complications. B Show 2 more As per IDSA 2012 guidelines: Reassess initial management in patients who worsen despite 48-72 hours of initial antibiotic therapy, or who fail to improve despite 3-5 days of antibiotic therapy. B https://web.pathway.md/diseases/recWH9VnX7b3GYOHL 3/5 6/23/23, 1:37 AM Acute bacterial rhinosinusitis Pathway Evaluate for the presence of factors associated with treatment failure (such as resistant pathogens, structural abnormalities, or a noninfectious etiology) in patients who worsen despite 72 hours of initial antibiotic therapy, or who fail to improve despite 3-5 days of antibiotic therapy. B Likelihood Ratios Pertinent positives The following findings increase the probability of acute bacterial rhinosinusitis in adults. 1 1 Finding LR+ Value Presence of any 4 of 5 clinical findings of acute sinusitis* 6.4 (2.2-19) Presence of halo sign 4.8 Presence of air-fluid levels 4.2 (2.6-6.7) History of maxillary toothache 2.6 maxillary toothache, purulent nasal secretion, poor response to decongestant, abnormal transillumination result, patient report of colored nasal discharge Show 11 more Pertinent negatives The following findings decrease the probability of acute bacterial rhinosinusitis in adults. 1 1 Finding LR- Value Absence of sinus opacification 0.01 Absence of air-fluid levels 0.26 (0.17-0.37) Absence of halo sign 0.3 Negative transillumination test 0.5 Show 10 more References 1. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152 2 Suppl):S1 S39. Open 2. Chow AW, Benninger MS, Brook I et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. Clin Infect Dis. 2012 Apr;54 8):e72-e112. Open 3. Wald ER, Applegate KE, Bordley C et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. Pediatrics. 2013 Jul;132 1):e262 80. Open 4. Anthony W Chow, Michael S Benninger, Itzhak Brook et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. 2012 Apr;54 8):e72-e112.2012 Apr;54 8):e72-e112. Open https://web.pathway.md/diseases/recWH9VnX7b3GYOHL 4/5 6/23/23, 1:37 AM Acute bacterial rhinosinusitis Pathway 5. Patorn Piromchai, Sanguansak Thanaviratananich. Invasive fungal rhinosinusitis versus bacterial rhinosinusitis with orbital complications: a case-control study. 2013 Nov 3;2013 453297.2013 Nov 3;2013 453297. Open 6. American Association of Family Physicians. Choosing Wisely AAFP recommendations. Choosing Wisely. 2012. Open 7. American College of Emergency Physicians. Choosing Wisely ACEP recommendations. Choosing Wisely. 2014. Open 8. American Academy of Allergy, Asthma & Immunology. Choosing Wisely AAAAI recommendations. Choosing Wisely. 2012. Open 9. American Academy of Ophthalmology. Choosing Wisely AAO recommendations. Choosing Wisely. 2013. Open 10. Aaron M Harris, Lauri A Hicks, Amir Qaseem et al. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016 Mar 15;164 6 425 34. Open 11. Anthony W Chow, Michael S Benninger, Itzhak Brook et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012 Apr;54 8):e72-e112. Open 12. Roger Zoorob, Mohamad A Sidani, Richard D Fremont et al. Antibiotic use in acute upper respiratory tract infections. Am Fam Physician. 2012 Nov 1;86 9 817 22. Open https://web.pathway.md/diseases/recWH9VnX7b3GYOHL 5/5