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Patience & watchful waiting – Key to antibiotic stewardship

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A recent guideline for treatment of sinusitis suggests that most viral sinusitis is persistently symptomatic for nearly 2 weeks.(1) The symptoms peak at 2 – 3 days time and resolve without any antibiotic treatment by 14 days or so. This suggests a longer watcful waiting period before using antibiotics for treatment of sinusitis. Most sinusitis are of viral origin and antibiotics do not have a role in the treatment of such viral sinusitis. Symptomatic relief could be obtained by using intranasal steroids, saline nasal drops, inhalation of steam and with use of analgesics. “Watchful waiting” is beneficial to a great extent and the infection subsides in about the same time it takes even with the use of antibiotics indicating the futility of routine antibiotic usage in sinus infections. Continue reading

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