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Acute bacterial rhinosinusitis in children: Microbiology and treatment

Ellen R Wald, MD
Section Editors
Sheldon L Kaplan, MD
Glenn C Isaacson, MD, FAAP
Robert A Wood, MD
Deputy Editor
Mary M Torchia, MD


Acute rhinosinusitis is a disease that results from infection of one or more of the paranasal sinuses. A viral infection associated with the common cold is the most frequent etiology of acute rhinosinusitis, more properly called viral rhinosinusitis. (See "The common cold in children: Clinical features and diagnosis" and "The common cold in children: Management and prevention".)

Uncomplicated viral rhinosinusitis usually resolves without treatment in 7 to 10 days. Although untreated acute bacterial rhinosinusitis (ABRS) also may resolve without treatment, treatment with antibiotics hastens recovery [1,2]. It is important to distinguish between uncomplicated viral rhinosinusitis and ABRS to prevent unnecessary use of antibiotics (table 1).

The microbiology and treatment of ABRS in children will be discussed here. The clinical features and diagnosis of ABRS in children and acute sinusitis and rhinosinusitis in adults are discussed separately. (See "Acute bacterial rhinosinusitis in children: Clinical features and diagnosis" and "Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis" and "Uncomplicated acute sinusitis and rhinosinusitis in adults: Treatment".)


The clinical presentation of acute bacterial rhinosinusitis in children is characterized by [3-8]:

Persistent symptoms (nasal discharge or cough or both) for >10 days without improvement, or

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Literature review current through: Nov 2017. | This topic last updated: Aug 04, 2017.
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