Table 3.
Antibiotic therapy for acute bacterial sinusitis
| Antibiotic | Treatment | Adult dosage | Pediatric dosage | Data | Level of evidence |
|---|---|---|---|---|---|
| First-line antibiotics | |||||
| Amoxicillin | 10 d | 500 mg bid | 45 mg/kg bid | Increased recovery rates compared with placebo at 2 wk | Aa[34], [35] |
| If no response after 72 h, re-evaluate and consider alternative antibiotics | 7–10 d of amoxicillin significantly increased complete symptom resolution compared with placebo | ||||
| Doxycycline | 100 mg bid | 2.2 mg/kg bid | Increased recovery rates compared with placebo at 2 wk | Aa[34] | |
| Trimethoprim-sulfamethoxazole | 160/800 mg bid | 40/200 mg/kg bid | |||
| Alternative antibiotics | |||||
| Amoxicillin/clavulanate | 500–875 mg bid | 22.5–45 mg/kg bid | |||
| Cefpodoxime | 200–400 mg bid | 5 mg/kg bid | |||
| Cefuroxime | 250–500 mg bid | 7.5 mg/kg bid | |||
| Cefixime | 400 mg qd | 8 mg/kg qd | |||
| Azithromycin | 250 mg qd | 5 mg/kg qd | |||
| Clarithromycin | 500 mg bid | 7.5 mg/kg bid | |||
| Levofloxacin | 500 mg bid | ||||
Blank entry, not recommended.
a
Level A is consistent, good-quality patient-oriented evidence (SORT evidence rating system).