Table 1.

Summary of Recommended Treatment Options for Outpatient Acute Bacterial Rhinosinusitis in Adults¹⁵

Initial presentationa	Primary Option	Alternative Option
Antibiotic use in past month?	No; choose from Amoxicillin 1 g TID	Yes; choose from
	Cefdinir 300 mg Q12 h or 600 mg Q24 h	Augmentin XR 2000/125 mg BID
	Cefpodoxime 200 mg BID	If allergic to penicillin, choose from
	Cefprozil 250–500 mg BID	Gatifloxacin 400 mg Q24 h
	If allergic to penicillin, choose from	Levofloxacin 750 mg Q24 h × 5 d
	Moxifloxacin 400 mg Q24 h	Moxifloxacin 400 mg Q24 h
	Doxycycline100 mg BID
	TMP-SMX (Bactrim DS), 1 tablet BID
	Clarithromycin 500 mg BID or
	Clarithromycin ER 1 g Q24 h
Clinical failure after 3 days of initial therapyb	Mild or moderate disease, choose from	Severe disease, choose from
	Augmentin XR 2000/125 mg BID	Gatifloxacin 400 mg Q24 h
	Cefdinir 300 mg Q12 h or 600 mg Q24 h	Levofloxacin 750mg Q24 h × 5 d
	Cefpodoxime 200 mg BID	Moxifloxacin 400 mg Q24 h
	Cefprozil 250–500 mg BID

All regimens are for 10 days unless otherwise specified. TMP-SMX, trimethoprim and sulfamethoxazole; DS, double strength; ER, extended release.

^aPatients with fever and facial erythema are at increased risk of infection with Staphylococcus aureus, which warrants intravenous antibiotic therapy.

^bConsider referral to otolaryngologist for diagnostic aspiration and culture.