Still No Consensus on Antibiotics for Persistent Sinus Infection To prescribe or not prescribe?

The way that I distinguish an allergic sinusitis from a bacterial sinusitis is that when I have an allergic sinusitis, the symptoms improve within about a week to 10 days, but with a bacterial sinusitis I get physically weak and can't even get out of bed," the statement said. "When I go to a visit, I generally do not say, 'I want an antibiotic.' The doctor will ask me, 'Why are you here, and tell me about what is going on,' and I have found that, after reviewing my history, she ends up saying, 'I think you may need an antibiotic,'" Mr. X concluded. "I would delve into the patient's history a bit more, particularly with regard to prior episodes that were diagnosed as bacterial sinusitis, documentation of prior episodes of pneumonia, and his allergic reaction to ampicillin. Microbiological data and vaccination history would also be of interest, because this information may point to potentially useful preventive measures and/or clues to an immunodeficiency state. Use of intranasal steroids is appropriate for allergic rhinosinusitis, but because of the delayed effect of steroids, waiting until symptoms are 'bad' probably undermines their effectiveness," he stated. http://www.medpagetoday.com/Pulmonology/URIstheFlu/62949?xid=nl_mpt_DHE_2017-02-07&eun=g721819d0r&pos=2