Symptomatic therapy for uncomplicated acute rhinosinusitis
The following symptomatic therapy is recommended for patients with uncomplicated acute rhinosinusitis:
- oral analgesics (eg paracetamol, NSAIDs) – for adult dosages, see Oral drugs for mild, acute nociceptive pain in adults, or for child dosages, see Oral drugs for mild, acute nociceptive pain in children
- saline nasal preparations (sprays, rinses or drops)Fokkens, 2020
- an intranasal corticosteroid1Zalmanovici Trestioreanu, 2013 – for dosages, see Intranasal corticosteroids for allergic rhinitis
- a decongestant (see below).
Limited data indicate that decongestants may be beneficial if nasal congestion is the prominent symptom of uncomplicated acute rhinosinusitis. Intranasal decongestants should not be used for more than 5 days to avoid rebound congestion (rhinitis medicamentosa)Fokkens, 2020. For adults and children 6 years or older with uncomplicated acute rhinosinusitis, use:
oxymetazoline 0.05% nasal spray, 2 to 3 sprays into each nostril, 12-hourly if required for 3 to 5 days. oxymetazoline oxymetazoline oxymetazoline
It is unclear if oral decongestants (eg pseudoephedrine) provide a clinically significant improvement in symptoms of uncomplicated acute rhinosinusitisFokkens, 2020.
Oral corticosteroids should only be used for uncomplicated acute rhinosinusitis under specialist adviceVenekamp, 2014.
Oral antihistamines do not relieve symptoms of uncomplicated acute rhinosinusitis; they should only be considered if allergy is likely to be contributing to symptomsFokkens, 2020.