Acute Rhinosinusitis Protocol

Primary care screening, ABRS risk-stratification checker, and antibiotic workflows.

📊 Interactive ABRS Diagnostic Filter

Identify suspected Acute Rhinosinusitis (ARS) and screen for Acute Bacterial Rhinosinusitis (ABRS).

ABRS Diagnostic Criteria

Fever > 38°C Discoloured mucus Double sickening (Worsening after initial mild phase) Severe local pain Raised ESR / CRP

Recurrence Context

History of ≥ 3 ABRS episodes per year

Clinical Assessment:

Please tick the clinical signs present to generate a targeted pathway decision.

🚨 Red Flag Alarm Symptoms

The presence of any of these signs warrants immediate emergency referral to secondary/tertiary care.

Periorbital oedema / erythema
Displaced globe
Double vision (Diplopia)
Ophthalmoplegia
Reduced visual acuity

Severe, unrelenting headache
Frontal swelling
Signs of sepsis
Signs of meningitis
Neurological signs

*Chronic Symptoms: If rhinosinusitis symptoms persist continuously for ≥ 12 weeks without a symptom-free interval, arrange an immediate direct referral to ENT.

💊 Recommended Dosage (Adult Outpatient)

Indicated only if the criteria indicate likely bacterial involvement (ABRS) without referral risk factors.

Antibiotic Selection	Dosing Regimen	Duration	Remarks
Amoxicillin	500mg – 1000mg PO q8h	5 Days	Preferred
Amoxicillin / Clavulanate	625mg PO q8h	5 Days	Preferred
Doxycycline	100mg PO q12h	5 – 7 Days	Alternative
Azithromycin	500mg PO q24h	3 Days	Alternative* *Reserved for pregnant patients with a true penicillin allergy.

👶 Recommended Dosage (Children Outpatient)

Weight-based antibiotic options. Standard antimicrobial duration is 5 days for pediatric uncomplicated cases.

Antibiotic Selection	Weight-Based Dosing Regimen	Duration	Remarks
Amoxicillin	80 – 90 mg/kg/day PO split q12h (Max: 2gm / day)	5 Days	Preferred
Cefuroxime	30 mg/kg/day PO split q12h (Max: 1gm / day)	5 Days	Alternative