Systemic antibacterial therapy for acute bacterial sinusitis: An otorhinolaryngologist’s view

Acute sinusitis is an acute inflammation of the nasal mucosa and paranasal sinuses lasting less than 12 weeks. The disease is often included in the symptom complex of acute respiratory disease, the addition of bacterial pathogens was noted in 2% of clinical cases in adults and in 7–8% in children. The causative agents of acute purulent sinusitis in 70–75% of cases are Streptococcus pneumoniae and Haemophilus influenzae, in 15–20% – Streptococcus pyogenes, Moraxella catarrhalis, Staphylococcus aureus, anaerobes and others. The clinical manifestations of this pathology suggest that the symptoms of the disease persist for more than 10 days without significant improvement. In moderate to severe cases, systemic antibiotic therapy is prescribed empirically in accordance with the clinical recommendations of the National Medical Association of Otorhinolaryngologists, approved by the Russian Ministry of Health. To date, due to the emerging problem of microbial antibiotic resistance, the risk of chronic disease and complications due to the irrational use of systemic antibacterial drugs is increasing. The revision of the criteria for prescribing existing antibiotics leads to an increase in the dose of the most highly effective ones in order to completely eradicate the pathogen and prevent the selection of resistant strains. Empirical systemic antibacterial therapy for purulent-inflammatory diseases of the paranasal sinuses stops the inflammatory process, prevents the risks of intracranial and orbital complications. In 97.3–95% of cases, the results of microbiological studies show a high sensitivity of the most significant pathogens of respiratory infections to Amoxicillin, which is the drug of choice for inflammatory diseases of the sinuses in Russia and abroad. The presented clinical observation shows the need to comply with modern principles of rational antibiotic therapy in acute bacterial sinusitis.

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