Sinusitis
The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.
Analgesia, no antibiotic treatment (majority resolve in 14 days). Refer to prescribing notes.
2 sprays every 12 hours into each nostril.
If there is no response after 2 weeks, continue beclometasone and consider antibiotic treatment.
500mg every 6 hours for 5 days.
If penicillin allergic, prescribe doxycycline.
200mg on day 1, then 100mg daily for 5 days treatment in total.
In pregnancy and penicillin allergic.
500mg every 6 hours for 5 days.
Prescribing Notes:
- Ensure adequate use of analgesics.
- Evidence of benefit from nasal saline or nasal decongestants is lacking but may be considered for symptomatic relief.
- Antibiotics are not recommended for patients who are systemically well, not at risk of complications and symptom duration of less than 10 days. If there is no improvement after 10 days, consider delayed antibiotic prescription depending on likelihood of bacterial cause.
- Antibiotics can be considered for patients with suspected acute bacterial sinusitis when at least three of the following are present (or if the patient is at high risk of complications):
- discoloured or purulent discharge (with unilateral predominance)
- severe local pain (with unilateral predominance)
- a fever greater than 38 degrees Celsius
- a marked deterioration after an initial milder form of the illness (so-called 'double-sickening')
- elevated ESR/CRP (although the practicality of this criterion is limited).
History Notes
30/07/2026
Regional formulary chapter launched.