Update on acute sinusitis in children

Sinusitis is one of the most common diseases presented to the primary care practioner. In this setting it is key to distinguish those children who have uncomplicated viral upper respiratory tract infection from those who have acute bacterial sinusitis. Sinusitis may be diagnosed based on the presence of persistent or severe respiratory symptoms or when a respiratory illness has a biphasic presentation. Radiographs or computed tomography scans are not usually needed to diagnose sinusitis in children. Well-designed randomized, controlled trials demonstrated the benefit of antibiotics compared to placebo. Antimicrobial therapy should be targeted against the three major pathogens responsible for sinusitis, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Amoxicillin or amoxicillin/clavulanate are the antibiotics of choice for children with acute bacterial sinusitis.