New Strategies for the Management of Sinusitis
Jeffrey Adelglass, MD
Dallas Clinical Research, Dallas, Texas, USA
Sinusitis is one of the most common presenting complaints in community practice. Although poor sensitivity and specificity of presenting signs and symptoms make accurate diagnosis difficult, treatment of bacterial sinusitis is important to relieve the acute symptoms and to prevent recurrence. In addition, prompt, effective antimicrobial therapy of bacterial sinusitis is essential to avoid the potential intracranial complications that may follow such as meningitis, epidural or subdural empyema, brain abscess, and cavernous sinus and cortical vein thrombosis. Although -lactam antimicrobials, tetracyclines, macrolides and sulfa drugs have been the drugs of choice for years, there has been concern recently that they may not be adequate. Newer approaches include the quinolone antimicrobials such as levofloxacin which is active against many resistant pathogens of acute sinusitis.