Management of Acute Pediatric Rhinosinusitis

Purpose of Review The goal of this paper is to discuss the current diagnostic criterion, pharmaceutical, and surgical treatments for pediatric acute rhinosinusitis with and without complications. Recent Findings The use of balloon sinuplasty to treat complicated acute frontal sinusitis, in the pediatric population, has been shown to be safe and effective. Summary Pediatric upper respiratory infections and acute bacterial rhinosinusitis are two of the most common diagnoses made in outpatient pediatric office visits. The majority of pediatric acute rhinosinusitis illnesses can be treated with conservative measures. Amoxicillin or amoxicillin with clavulanic acid is the first-line empiric therapy for the treatment of acute rhinosinusitis. These oral antibiotics are recommended if symptoms persist for 10 days or more, are associated with a double sickening, or present with severe symptoms. Further data on the efficacy of amoxicillin versus amoxicillin-clavulanate is needed to confirm the appropriate first-line oral antibiotic for ABRS. A high index of suspicion, prompt diagnosis, and immediate intravenous (IV) antibiotic therapy may reduce the necessity for surgical intervention to treat complications of acute bacterial rhinosinusitis (ABRS). Future research on the benefits of preventative therapies such as supplements and hand hygiene education would be helpful in reducing the risk of contracting viruses that may lead to bacterial rhinosinusitis complications.