Acute Bacterial Rhinosinusitis

  • Zara M. PatelEmail author
  • Peter H. Hwang


Acute bacterial rhinosinusitis (ABRS) is a highly prevalent disease associated with significant direct and indirect costs. It is paramount that a practitioner can distinguish between acute viral rhinosinusitis and ABRS to avoid unnecessary antibiotic usage. It is also important to understand that establishing a diagnosis of ABRS does not necessitate the prescribing of antibiotics, unless the ABRS patient presents with severe or worsening symptoms or an ABRS complication. Complications include extension of infection to the orbit and central nervous system. Injudicious use of antibiotics imparts societal costs in terms of financial expense as well as contributing to higher levels of bacterial resistance. This chapter reviews the epidemiology, clinical features, diagnosis, and treatment of ABRS.


Acute sinusitis Acute rhinosinusitis Acute bacterial sinusitis Sinusitis Acute viral rhinosinusitis Viral rhinosinusitis Upper respiratory infection Common cold 


  1. 1.
    Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg. 2004;131:S1.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152:S1–S39.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat. 2014;10:1.Google Scholar
  4. 4.
    Wilson JF. In the clinic. Acute sinusitis. Ann Intern Med. 2010;153:ITC31.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Anon JB, Jacobs MR, Poole MD, et al. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg. 2004;130(suppl):1–45.PubMedGoogle Scholar
  6. 6.
    Rudmik L, Smith TL, Schlosser RJ, et al. Productivity costs in patients with refractory chronic rhinosinusitis. Laryngoscope. 2014;124(9):2007–12.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Kaszuba SM, Stewart MG. Medical management and diagnosis of chronic rhinosinusitis: a survey of treatment patterns by United States otolaryngologists. Am J Rhinol. 2006;20(2):186–90.PubMedCrossRefGoogle Scholar
  8. 8.
    Rosenfeld RM. Clinial practice. Acute Sinusitis in Adults. N Engl J Med. 2016;375:962.CrossRefPubMedGoogle Scholar
  9. 9.
    Gwaltney JM Jr. Acute community-acquired sinusitis. Clin Infect Dis. 1996;23:1209.CrossRefPubMedGoogle Scholar
  10. 10.
    Turner RB. The common cold. In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 8th ed. Philadelphia, PA: Elsevier (Saunders); 2015. p. 749–52.Google Scholar
  11. 11.
    Fokkens W, Lund V, Mullol J, et al. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology. 2007;45:97.PubMedGoogle Scholar
  12. 12.
    Evans FO Jr, Sydnor JB, Moore WE, et al. Sinusitis of the maxillary antrum. N Engl J Med. 1975;293:735.CrossRefPubMedGoogle Scholar
  13. 13.
    George DL, Falk PS, Umberto Meduri G, et al. Nosocomial sinusitis in patients in the medical intensive care unit: a prospective epidemiological study. Clin Infect Dis. 1998;27:463.CrossRefPubMedGoogle Scholar
  14. 14.
    Geiss HK. Nosocomial sinusitis. Intensive Care Med. 1999;25:1037.CrossRefPubMedGoogle Scholar
  15. 15.
    Gwaltney JM Jr, Hendley JO, Simon G, Jordan WS Jr. Rhinovirus infections in an industrial population. II. Characteristics of illness and antibody response. JAMA. 1967;202:494.CrossRefPubMedGoogle Scholar
  16. 16.
    Bird J, Biggs TC, Thomas M, Salib RJ. Adult acute rhinosinusitis. BMJ. 2013;346:f2687.CrossRefPubMedGoogle Scholar
  17. 17.
    Low DE, Desrosiers M, McSherry J, et al. A practical guide for the diagnosis and treatment of acute sinusitis. CMAJ. 1997;156(Suppl 6):S1.PubMedGoogle Scholar
  18. 18.
    Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80(9):1414–28.CrossRefPubMedGoogle Scholar
  19. 19.
    Chow AW, Benninger MS, Brook I, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012;54:e72.CrossRefPubMedGoogle Scholar
  20. 20.
    Benninger MS, Payne SC, Ferguson BJ, et al. Endoscopically directed middle meatal cultures versus maxillary sinus taps in acute bacterial maxillary rhinosinusitis: a meta-analysis. Otolaryngol Head Neck Surg. 2006;134:3.CrossRefPubMedGoogle Scholar
  21. 21.
    Hwang PH. A 51-year-old woman with acute onset of facial pressure, rhinorrhea, and tooth pain: review of acute rhinosinusitis. JAMA. 2009;301:1798.CrossRefPubMedGoogle Scholar
  22. 22.
    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;132:e262-e280.CrossRefGoogle Scholar
  23. 23.
    Lemiengre MB, van Driel ML, Merenstein D, et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev. 2012;10:CD006089.PubMedGoogle Scholar
  24. 24.
    De Sutter A, Lemiengre M, Van Maele G, et al. Predicting prognosis and effect of antibiotic treatment in rhinosinusitis. Ann Fam Med. 2006;4(6):486–93.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Bucher HC, Tschudi P, Young J, et al. Effect of amoxicillin-clavulinate in clinically diagnosed acute rhinosinusitis. A placebo-controlled, double-blind, randomized trial in general practice. Arch Intern Med. 2003;163:1793–8.CrossRefPubMedGoogle Scholar
  26. 26.
    FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Accessed on 28 February 2017.
  27. 27.
    King D, Mitchell B, Williams CP, Spurling GK. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015:CD006821.Google Scholar
  28. 28.
    Zalmanovici Trestioreanu A, Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database Syst Rev. 2013:CD005149.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck SurgeryStanford University School of MedicineStanfordUSA

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