Short (5 Days) Versus Long (14 Days) Duration of Antimicrobial Therapy for Acute Bacterial Sinusitis in Children

This was a prospective, randomized, double-blind study comparing short course (5 days) to long course (14 days) antimicrobial therapy for children between 1 and 10 years of age with acute bacterial sinusitis. The major outcome measure is the proportion of children with a clinical relapse on day 10 in the short course therapy group compared to day 20 in the long course therapy group. In addition, the proportion of respiratory flora that are resistant to antibiotics on day 30 will be compared to baseline in each group.

Inclusion criteria

• children with nasal discharge (of any quality) or daytime cough (which may be worse at night) or both persisting for 10 days or more without evidence of improvement.
• families need to be English speaking

Exclusion criteria

• used antibiotics within the last 15 days;
• had symptoms for > 30 days;
• have concurrent streptococcal pharyngitis or acute otitis media (as the standard doses for both of these conditions is 10 days);
• are allergic to penicillin;
• have symptoms that suggest a complication due to acute bacterial sinusitis that necessitates hospitalization, intravenous antibiotics or sub-specialty evaluation
• been diagnosed with either immunodeficiency or anatomic abnormality of the upper respiratory tract
• history of recurrent acute sinusitis (more than 3 episodes in 6 months or 4 episodes in a year)
• history of chronic sinusitis (more than 90 days of respiratory symptoms in this or the previous respiratory season)
• girls who have begun menstruating