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تعداد آیتم قابل مشاهده باقیمانده : -8 مورد

Oral antibiotic treatment options for acute bacterial rhinosinusitis in adults

Oral antibiotic treatment options for acute bacterial rhinosinusitis in adults
  Dose Comments
First-line options for initial therapy
Amoxicillin 500 mg 3 times daily or 875 mg twice daily  
Amoxicillin-clavulanate

Standard dose (immediate-release): 500 mg/125 mg 3 times daily or 875 mg/125 mg twice daily

High dose (extended-release): 2 g/125 mg twice daily

 High dose is appropriate for individuals who:
  • Have risk factors for resistant pneumococcus*
  • or
  • Are undergoing subsequent therapy after failure of initial therapy
Alternatives
Doxycycline 100 mg twice daily or 200 mg once daily Preferred initial therapy in patients with penicillin allergy who are not able to tolerate any beta-lactam agent
Third-generation cephalosporin ± clindamycin Cefixime 400 mg once daily We reserve the addition of clindamycin for individuals who:
  • Have risk factors for resistant pneumococcus*
  • or
  • Are undergoing subsequent therapy after failure of initial therapy
Cefpodoxime 200 mg twice daily

Clindamycin

(in combination with either of the above third-generation cephalosporins)

 300 mg every 6 hours
Respiratory fluoroquinolones Levofloxacin 500 mg once daily or 750 mg once daily Fluoroquinolones should be reserved for those without alternative treatment options due to the risk of serious adverse effects
Moxifloxacin 400 mg once daily
For agent selection and treatment duration, refer to UpToDate content on acute bacterial rhinosinusitis. Dosing in this table is intended for nonpregnant adults with normal kidney function; refer to the drug monographs included within UpToDate for dose adjustments.
* Risk factors for resistant pneumococcus include living in a geographic region with rates of penicillin-nonsusceptible Streptococcus pneumoniae exceeding 10%, age ≥65, hospitalization in the last 3 months, antibiotic use in the last 3 months, immunocompromising condition, multiple comorbidities, and severe infection (eg, evidence of systemic toxicity or threat of suppurative complications).
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