What is the first-line treatment for acute bacterial sinusitis?

The first-line treatment for acute bacterial sinusitis is amoxicillin or amoxicillin-clavulanate. This choice is guided by clinical guidelines which recommend these antibiotics due to their effectiveness against the most common bacterial pathogens associated with acute bacterial sinusitis, including Streptococcus pneumoniae and Haemophilus influenzae.

Amoxicillin is preferred because it is effective, has a favorable side effect profile, and is generally well-tolerated. In cases where there is a concern about antibiotic resistance or in patients with a history of recurrent infections, amoxicillin-clavulanate is often chosen to provide broader coverage, particularly against beta-lactamase producing organisms.

Other antibiotic options serve specific situations or patient populations. For instance, while azithromycin and doxycycline can be effective in managing other types of respiratory infections, they are not considered first-line for acute bacterial sinusitis, largely due to concerns about resistance patterns. Similarly, trimethoprim-sulfamethoxazole is not typically recommended because bacterial resistance and a less favorable side effect profile compared to amoxicillin impact its use.

In summary, the preference for amoxicillin or amoxicillin-clavulanate as first-line treatment is rooted in their proven efficacy, safety profile