Hostname: page-component-6766d58669-zlvph Total loading time: 0 Render date: 2026-05-21T04:02:30.380Z Has data issue: false hasContentIssue false
  • English
  • Français

Antibiotic choice in acute and complicated sinusitis

Published online by Cambridge University Press:  29 June 2007

S. Mortimore ,
P. J. Wormald  and
S. Oliver
S. Mortimore*
Affiliation:
Departments of Otorhinolaryngology, Groote Schuur Hospital, Cape Town, South Africa.
P. J. Wormald
Affiliation:
Departments of Otorhinolaryngology, Groote Schuur Hospital, Cape Town, South Africa.
S. Oliver
Affiliation:
Departments and Medical Microbiology, Groote Schuur Hospital, Cape Town, South Africa.
*
Address for correspondence: S. Mortimore, Department of Otorhinolayngology, head and Neck Surgery, Whiston Hospital, Merseyside L35 5DR.
Get access Rights & Permissions [Opens in a new window]

Abstract

The microbiology of 87 patients admitted to hospital, over a five-year period, with acute sinusitis was retrospectively analysed. Sixty-three patients had one or more of an orbital, intracranial, soft tissue or bony complication. Eighty-four patients had maxillary sinus washouts, while 48 required a surgical procedure to their sinuses, and 33, drainage of an empyema. Streptococcus milleri and Haemophilus influenzae were the commonest organisms isolated from sinus aspirates (44 per cent), with a noticeable absence of Streptococcus pneumoniae (10 per cent). Organisms cultured from intracranial, soft tissue or orbitral empyemas were predominantly Streptococcus milleri (50 per cent) and Staphylococcus aureus (25 per cent) with an absence of Haemophilus influenzae (four per cent) and Streptococcus pneumoniae (four per cent). Ampicillin is an appropriate first line antimicrobial agent in patients with acute complicated sinusitis with the addition of cloxacillin in cases with an empyema. Chloramphenicol or ceftriaxone is used in cases with an intracranial complication.

Keywords

SinusitismicrobiologyAntibiotics

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 3 , March 1998 , pp. 264 - 268
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Axelsson, A., Brorson, J. E. (1973) The correlation between bacteriological findings in the nose and maxillary sinus in acute maxillary sinusitis. Laryngoscope 83: 2003–2011.CrossRefGoogle ScholarPubMed
Baker, A. S. (1991) Role of anaerobic bacteria in sinusitis and its complications. Annals of Otology, Rhinology and Laryngology (Suppl)154: 17–22.CrossRefGoogle ScholarPubMed
Cherry, J. (1988) Letter to the Editor. Journal of the Royal Society of Medicine 81: 142.Google Scholar
Edelstein, D. R., Avner, S. E., Chow, J. M., Duerksen, R. L., Johnson, J., Ronis, M., Rybak, L. P., Bierman, W. C., Matthews, B. L., Kohlbrenner, V. M., (1993) Once-a-day therapy for sinusitis: a comparison study of cefixime and amoxicillin. Laryngoscope 103(1): 33–41.CrossRefGoogle ScholarPubMed
Giannoni, C. M., Stewart, M. G., Alford, E. L., (1997) Intracranial complications of sinusitis. Laryngoscope 107: 863–867.CrossRefGoogle ScholarPubMed
Goodwin, W. J., (1985) Orbital complications of ethmoiditis. Otolaryngologic Clinics of North America 18: 139–147.CrossRefGoogle ScholarPubMed
Gwaltney, J. M., Scheld, M., Sande, M. A., Sydnor, A. (1992) The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: A 15-year experience at the University of Virginia and review of other selected studies. Journal of Allergy and Clinical Immunology 90(3): 457–461.CrossRefGoogle Scholar
Gwaltney, J. M., Sydnor, A., Sande, M. A., (1981) Etiology and antimicrobial treatment of acute sinusitis. Annals of Otorhinolaryngology 90(SuppI 84): 68–71.Google ScholarPubMed
Jousimies-Somer, H. R., Savolainen, S., Ylikoski, J. S., (1988) Journal of Clinical Microbiology 26(10): 1919–1925.CrossRefGoogle Scholar
Osguthorpe, J. D., Hochman, M., (1993) Inflammatory sinus diseases affecting the orbit. Otolaryngologic: Clinics of North America 26(4): 657–671.Google ScholarPubMed
Peter, J. C., Bok, A. P., (1994) Rhinogenic subdural empyema in older children and teenagers. South African Medical Journal 84(12): 847–849.Google ScholarPubMed
Rosenfeld, E. A., Rowley, A. H., (1994) Infectious intracranial complications of sinusitis, other than meningitis, in children: 12-year review. Clinical Infectious Diseases 18(5): 750–754.CrossRefGoogle ScholarPubMed
Samad, I., Riding, K., (1991) Orbital complications of ethmoiditis: B.C. Children's Hospital experience, 1982–1989. Journal of Otolaryngology 20(6): 400–403.Google Scholar
Schramm, V. L., Curtin, H. D., Kennerdell, J. S., (1982) Evaluation of orbital cellulitis and results of treatment. Laryngoscope 92: 732–738.CrossRefGoogle ScholarPubMed
Shurin, P. A., (1981) Etiology and antimicrobial therapy of paranasal sinusitis in children. Annals of Otology, Rhinol-ogy and Laryngology (Suppl) 90(3): 72–74.Google Scholar
Swift, A. C., Charlton, G., (1990) Sinusitis and the acute orbit in children. Journal of Laryngology and Otology 104: 213–216.CrossRefGoogle ScholarPubMed
Wald, E. R., (1992) Microbiology of acute and chronic sinusitis in children. Journal of Allergy and Clinical Immunology 90(3): 452–156.CrossRefGoogle ScholarPubMed
Williams, S. R., Carruth, J. A. S., (1992) Orbital infection secondary to sinusitis in children: diagnosis and management. Clinical Otolaryngology 17: 550–557.CrossRefGoogle ScholarPubMed