Table 3. Summary of Key Action Statements (KAS)
(continued)
Statement Action Strength
7a. Diagnosis
of CRS or
recurrent ARS
Clinicians should distinguish CRS and recurrent
ARS from isolated episodes of ABRS and other
causes of sinonasal symptoms.
R-C
7b. Objective
confirmation of
a diagnosis of
CRS
Clinicians should confirm a clinical diagnosis of
CRS with objective documentation of sinonasal
inflammation, which may be accomplished using
anterior rhinoscopy, nasal endoscopy, or computed
tomography.
S-B
8. Modifying
factors
Clinicians should assess the patient with CRS or
recurrent ARS for multiple chronic conditions that
would modify management, such as asthma, cystic
fibrosis, immunocompromised state, and ciliary
dyskinesia.
R-B
9. Testing
for allerg y
and immune
function
Clinicians may obtain testing for allerg y and immune
function in evaluating a patient with CRS or
recurrent ARS.
O-C
10. CRS with
polyps
Clinicians should confirm the presence or absence of
nasal polyps in a patient with CRS
R-A
11. Topical
intranasal
therapy for CRS
Clinicians should recommend saline nasal irrigation,
topical intranasal corticosteroids, or both, for
symptom relief of CRS
R-A
12. Antifungal
therapy for CRS
Clinicians should NOT prescribe topical or systemic
antifungal therapy for patients with CRS.
R-A against
a
Watchful waiting can be implemented using a WASP (wait-and-see antibiotic prescription) or
SNAP (safety-net antibiotic prescription) and by informing the patient to fill the prescription and
begin antibiotic therapy if they fail to improve within 7 days or if they worsen at any time.
b
For penicillin-allergic patients either doxycycline or a respiratory fluoroquinolone (levofloxacin or
moxifloxacin) is recommended.
