Pediatric emergency medicine trisk 2366 2366
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e-TABLE 94.5
TREATMENT OF ACUTE BACTERIAL SINUSITIS
Scenario
Antibiotic
Dose a
Uncomplicated,
Amoxicillin
antibiotic resistance
not suspected
80–90 mg/kg/day (maximum:
2 g/dose)
Moderate to severe
illness, daycare
attendees, children
recently treated
with amoxicillin
Amoxicillinclavulanate
80–90 mg/kg/day of
amoxicillin component
(maximum: 2 g/dose)
Penicillin-allergic
patients
Second- or thirdgeneration
cephalosporin
Cefuroxime 15 mg/kg bid
(maximum: 1 g/day) for
preadolescents; 250 mg bid
for adolescents
Cefdinir 14 mg/kg daily
(maximum: 600 mg/day)
Cefpodoxime 10 mg/kg bid
(maximum: 200 mg/dose)
Cefixime 8 mg/kg/day
(maximum: 400 mg/day)
Clindamycin 10 mg/kg tid
(maximum: 600 mg/dose)
PenicillinCefixime +
anaphylactic
clindamycin
patients <2 yrs of
age with moderate–
severe sinusitis
a The
optimal duration of therapy for sinusitis is unclear. As opposed to selecting a single treatment
duration, some experts recommend continuation of treatment for at least 7 days after patient becomes
asymptomatic.
