5
Table 2. Summary of Guideline Key Action Statements (KAS)
(cont'd)
Statement Action Strength
7b. Objective
confirmation of a
diagnosis of CRS
e clinician 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.
Strong
recommendation
8. Modifying factors Clinicians should assess the patient with CRS
or RARS for multiple chronic conditions that
would modify management such as asthma,
cystic fibrosis, immunocompromised state,
aspirin-exacerbated respiratory disease, and
ciliary dyskinesia.
Recommendation
9. Testing for allerg y
and immune
function
e clinician may obtain testing for allerg y
and immune function in evaluating a
patient with CRS or RARS.
Option
10. CRS with polyps e clinician should confirm the presence or
absence of nasal polyps in a patient with CRS.
Recommendation
11. Topical intranasal
therapy for CRS
Clinicians should recommend saline nasal
irrigation, topical intranasal corticosteroids,
or both, for symptomatic relief of CRS.
Recommendation
12. Antifungal
therapy for CRS
Clinicians should not prescribe topical or
systemic antifungal therapy for patients
with CRS.
Recommendation
(against therapy)
13a. Biologics and
Lack of Benefit
for CRS without
Polyps
Clinicians should not routinely prescribe
biologics (including, but not limited to,
monoclonal antibodies such as dupilumab,
mepolizumab, or omalizumab) for the
treatment of adults with CRS without
polyps.
Recommendation
(against therapy)
13b. Biologics
and Patient
Education
Clinicians or their designee should educate
patients with CRS with nasal polyps about the
role of biologics as a means to improve disease-
specific quality of life when either prior
medical and surgical therapy has failed OR
when surgery is not a viable option because of
disease status or patient preference.
Recommendation
14. Antibiotics and
CRS
Clinicians should not routinely prescribe
antimicrobial therapy for adults with
CRS without acute exacerbation OR as a
mandatory prerequisite for paranasal sinus
imaging or surgery.
Recommendation
(against therapy)
