Current Status of Treatment of Pediatric Rhinosinusitis According to Private Practitioners

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  • 開業医からみた小児鼻副鼻腔炎診療の実際
  • カイギョウイ カラ ミタ ショウニ ビ フクビコウエン シンリョウ ノ ジッサイ

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<p></p><p>1. Pediatric acute rhinosinusitis shares several common features with adult acute rhinosinusitis that occurs in pregnant women as quinolone antibiotics generally cannot be used in either condition. </p><p>2. In patients with severe acute rhinosinusitis accompanied by fever, initiation of intravenous ceftriaxone infusion at the time of initial examination is one of the recommended treatment options. </p><p>3. If Haemophilus influenzae is the pathogenic bacteria, azithromycin (AZM) is one of the antibiotic options. </p><p>4. In patients with persistent rhinosinusitis, administration of the usual dosage of clarithromycin for 1–2 weeks is effective. However, if acute exacerbation is diagnosed via endoscopy, switching to high-dose penicillin or cephem antibiotics or AZM is crucial. </p><p>5. If mucopurulent nasal discharge is noted in a case of allergic rhinitis, an associated complication of paranasal sinusitis is suspected. Although careful monitoring of the patient’s course is important, antibiotics are often unnecessary. </p><p>6. For patients aged 0–2 years with acute rhinosinusitis, antibiotics are unnecessary if there is no complicating otitis media and if the general condition is good. </p><p>7. If the causative organism is anaerobic bacteria, the condition may become chronic. </p>

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