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Sinusitis

Sinusitis  Possible therapeutic alternatives
Sinusitis (Acute) symptoms < 4 weeks.

Usual duration of therapy: 10-14 days

 

Common pathogens
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) Common pathogens
Same as above. Surgery may be required. Consider reserving antibiotic therapy for acute flares only.
Sinusitis (Hospitalized patient) Intubated etc. Common pathogens
Treatment should be based on culture results
[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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Sinusitis