The management of rhinosinusitis in general practice

Keywords: rhinosinusitis, nasal saline, corticosteroids, antibiotics, multidisciplinary approach


Rhinosinusitis is a very common disease in general practice. Usually, patients present with acute symptoms, and an accurate diagnosis is made from the history and clinical examination without the need for laboratory and radiological investigations. When the duration of the symptoms does not exceed 10 days, a viral aetiology is most likely, treatment is targeted towards the relief of symptoms, antibiotics are not recommended, and most cases will resolve. However, if symptoms intensify after the 5th day, or extend beyond the 10th day, a secondary bacterial infection is indicated and the use of antibiotics justified. The recommended first line of antibiotic treatment is either amoxicillin or amoxicillin-clavulanate. Until patients are fully recovered, doctors need to remain vigilant because some may instead develop recurrent and chronic diseases or life-threatening complications. General practitioners (GPs) should be familiar with the early warning signs that herald the onset of detection of complications to ensure timely intervention.

Author Biographies

I P Olwoch, University of Limpopo

School of Medicine, University of Limpopo, South Africa

M Kotu, Sefako Makgatho Health Sciences University

Department of Otorhinolaryngology, Sefako Makgatho Health Sciences University, South Africa