The two primary bacterial pathogens associated with acute bacterial rhinosinusitis are Streptococcus pneumoniae and Haemophilus influenzae, accounting for close to 80% of bacterial infections (6, 7). The less common organisms associated with acute rhinosinusitis include other Streptococcus spp., Moraxella catarrhalis, anaerobes and some Staphylococcus spp. In chronic bacterial rhinosinusitis, there is a typical shift toward multiple, more antibiotic-resistant organisms, with a decrease in impact of the Streptococcus spp.