Sinusitis (acute): antimicrobial prescribing

Acute sinusitis (also known as rhinosinusitis) is self-limiting and usually triggered by a viral infection of the upper respiratory tract (for example, a common cold).

Only about 2% of cases are complicated by bacterial infection, but it is very difficult to distinguish these.

Symptoms can last for 2 to 3 weeks – most people will get better within this time without treatment, regardless of cause (bacteria or virus).

Antibiotics are not needed for most people. The number of people improving with antibiotics is similar to the number getting adverse effects, such as diarrhoea.

Complications of acute sinusitis are rare (about 2.5 to 4.3 per million people per year). Withholding antibiotics is unlikely to lead to complications.

Previous antibiotic use may lead to resistant organisms if the same antibiotic is used again.