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IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults
Jeanna Ray
Posted: Tuesday, August 28, 2012 3:47 PM
Joined: 6/6/2011
Posts: 4

This guideline addresses several issues in the management of acute bacterial rhinosinusitis (ABRS), including (1) inability of existing clinical criteria to accurately differentiate bacterial from viral acute rhinosinusitis, leading to excessive and inappropriate antimicrobial therapy; (2) gaps in knowledge and quality evidence regarding empiric antimicrobial therapy for ABRS due to imprecise patient selection criteria; (3) changing prevalence and antimicrobial susceptibility profiles of bacterial isolates associated with ABRS; and (4) impact of the use of conjugated vaccines for Streptococcus pneumoniae on the emergence of nonvaccine serotypes associated with ABRS. Read the full text guideline
Posted: Friday, December 28, 2012 11:04 AM
Joined: 8/23/2011
Posts: 1

I agree with your comments. A couple of concerns that I have is the antibiotic options.  amox/clav is fine but many insurance companies including medicaid still won't cover it.  Also to discount cephalosporins (weak, moderate recommendation) and go right to respiratory quinolones seems a bit agressive and as with amox/clav problems with coverage.  If the CAP guidelines from 2007 have not changed for S. pneumo coverage then why the change for ABRS?  I think the doxy is a nice option  for cost and insurance related issues but I would need to review our antibiogram for activity in the current time period against the most common bacterial pathogens.  I would like to see this algorithm reviewed but I agree with you still quite a lack of good scientific data andlimitations with diagnosis.

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