Bacterial sinusitis:

  1. Persistence and non-improvement of symptoms and signs of acute rhinosinusitis beyond 10 days.
  2. Worsening of symptoms or signs including new onset fever, headache or increase in nasal discharge following a typical viral URI that lasted 5-6 days and was initially improving (double sickening).
  3. Acute onset of high fever with facial pain or purulent nasal discharge for at least 3-4 days.
  4. The recommended treatment for patients with mild disease is amoxicillin and for severe cases/ history of prior antibiotic use or non response to first line therapy is co-amoxiclav. Treatment duration in adults is for 5-7 days and in children 10-14 days.