Table 7. Patient Information Sheet on Treating Acute Bacterial
Rhinosinusitis (ABRS)
Patient Question Clinician Answer
How long will it take before I
feel better?
Most patients with ABRS feel better within 7 days, and by
15 days about 90% are cured or improved.
Is there anything I can do for
symptomatic relief ?
ere are several ways to relieve sinusitis symptoms that
should be discussed with your doctor to decide which are
best for you:
1. Acetaminophen or ibuprofen can relieve pain and fever
2. Saline irrigations or washing out the nose with salt
water, can relieve symptoms and remove mucus that is
hard to blow out
3. Nasal steroid sprays can reduce symptoms after 15 days
of use, but the benefit is small (about 14 people must
use them to get 1 person better) and side effects include
headache, nasal itching, and nose bleeds
4. Decongestants may help you breathe easier and can be
taken as a nasal spray (for no more than 3 days in a row
to avoid worsening congestion) or by mouth
Is there anything I should not
do?
Antihistamines and oral steroid medicines should not be
used routinely because they have side effects and do not
relieve symptoms.
If I have ABRS do I have to take
an antibiotic?
No, both watchful waiting and antibiotic therapy are proven
ways to treat ABRS. Most people get better naturally, and
antibiotics only slightly increase symptom relief (about
10-15 people must use antibiotics to get 1 more person
better aer 7-15 days).
Is there any downside to using
antibiotic?
Antibiotics have side effects that include rash, upset
stomach, nausea, vomiting, allergic reactions, and causing
resistant germs.
What is "watchful waiting"
for ABRS?
Watchful waiting means delaying antibiotic treatment
of ABRS for up to 7 days aer diagnosis to see if you get
better on your own.
How is watchful waiting done? Your doctor can give you an antibiotic prescription, but
you should only fill the prescription and take the antibiotic
if you do not get better aer 7 days or if you get worse at
any time. If you do use the antibiotic, contact your doctor's
office and let them know.
If I use an antibiotic, for how
many days should I take it ?
Antibiotics are usually given for 10 days to treat ABRS,
but shorter courses may be equally effective. Ask your
doctor about a 5- to 7-day course of antibiotics since side
effects are less common.