Sinusitis

Possible therapeutic alternatives

Sinusitis (Acute) symptoms < 4 weeks.

Usual duration of therapy: 10-14 days

Augmentin 875/125 mg orally twice daily or 500/125mg three times daily or

Augmentin XR* 1000/62.5 mg 2 tablets orally twice daily.

*AUGMENTIN XR is contraindicated in patients with a creatinine clearance of < 30 mL/min. and in hemodialysis patients

Cefpodoxime (Vantin) 200mg twice daily x 10-14 days OR

Cefprozil (Cefzil) 500 mg orally twice daily OR

Ceftin (cefuroxime oral) 250mg orally twice daily or

Bactrim DS twice daily

Severe penicillin allergy:

Clarithromycin 500mg orally twice daily OR

Zithromax (Azithromycin) 500mg PO x 1, then 250mg PO qd x 4 days OR

Levofloxacin 750mg orally once daily

Drug resistant S.pneumo:

Levofloxacin 750mg orally once daily x 7-10 days

Chronic sinusitis (symptoms > 3 months)

Same as above. Surgery may be required. Consider reserving antibiotic therapy for acute flares only.

Sinusitis (Hospitalized patient) Intubated etc.

[Ceftazidime 1 to 2 grams IV every 8 hours + Tobramycin IV] or

Ciprofloxacin 400mg IV q12h or
Levofloxacin 500mg IV qd or or
moxifloxacin (Avelox) 400mg once daily

Cefepime 2 grams IV every 12 hours or

Imipenem 500mg IV every 6 hours

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