JAMA: 2009-05-06, Vol. 301, No. 17, Author in the Room™ Audio Interview

Interview with Peter H. Hwang, MD, author of A 51-Year-Old Woman With Acute Onset of Facial Pressure, Rhinorrhea, and Tooth Pain. Summary Points: 1. There are now published consensus guidelines for the diagnosis and treatment of acute rhinosinusitis. 2. Acute viral rhinosinusitis and acute bacterial rhinosinusitis can be difficult to distinguish in the first 10 days of symptoms. 3. Radiologic imaging is often "positive" in both viral and bacterial etiologies of acute sinusitis and therefore cannot be used to distinguish the two. 4. Oral antibiotics when prescribed appropriately confer a higher rate of partial or complete resolution of acute sinusitis symptoms compared to placebo. However, it should be noted that the spontaneous rate of resolution of acute bacterial rhinosinusitis may be as high as 40-60%. 5. Adjunctive therapies such as topical and oral decongestants may offer symptomatic relief but have not been proven to shorten the duration of illness.