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Cat, Staph) Immunocompromised patients could produce other infectious brokers including fungus First line: Amoxicillin, trimeth/sulfa, erythromycin, and others Second line: Amoxicillin/clavulanate, cefaroxime, clarithro mycin, azithromycin, clindamycin, levo?oxacin, gati?oxacin, and others 1354 Sinusitis Adjunctive therapies r Topical steroids, decongestants, mucolytics as indicated r Warm compresses r Humidi?cation r Nasal saline r Antipyretics Surgery r Maxillary sinus puncture for tradition/remedy in selected instances r Recurrent acute sinusitis may be handled efficiently with endoscopicoropentechniquestoreducefrequency,duration, intensity of infections В¦ Side Effects Medical r Allergy/response to antibiotic r Psuedomembranous colitis r Usualsideeffectsofdecongestants/steroids(seeRhinitischap ter) Surgery r Rare complication from maxillary sinus puncture r Rare orbital/intracranial or other complications of sinus surgery r Recurrence or persistence of infection r Unusual surgical complications (eg, bleeding, anesthesia related) r Rarely might require hospitalization for persistent infection, problems В¦ Chronic Sinusitis В¦ Antibioticsfor3weeks(samebacteriaasacutesinusitis+anaerobes, higher incidence of Staph, Pseudomonas) В¦ Immunocompromised sufferers might have other infectious brokers including fungus В¦ Treat with second line antibiotics as listed above В¦ Consider oral prednisone В¦ Topical nasal steroids Adjunctive Treatments Decongestants, mucolytics as indicated Humidi?cation Nasal saline Surgery Sinusitis 1355 r Chronic sinusitis could also be treated successfully with endoscopic or open techniques to scale back frequency, length, intensity of infections Side Effects Medical r Allergy/reaction to antibiotic r Pseudomembranous colitis r Usualsideeffectsofdecongestants/steroids(seeRhinitischap ter) Surgery r Rare orbital/intracranial or different issues of sinus surgery r Usualsurgicalcomplications(eg,bleeding,anesthesiarelated) r Rarely require hospitalization follow-up В¦ Acute Sinusitis 1 month as needed. 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