Evidence-Based Evaluation and Treatment of Acute Rhinosinusitis in Adults

Points & Pearls Excerpt

• Most acute rhinosinusitis is viral; <2% of cases progress to acute bacterial rhinosinusitis (ABRS).
• Diagnosis of acute rhinosinusitis is primarily clinical and should focus on symptom duration, progression, and the presence of nasal obstruction, purulent drainage, and facial pain or pressure.
• Routine laboratory testing and imaging are not indicated for uncomplicated rhinosinusitis; advanced imaging should be reserved for suspected complications or high-risk presentations.
• Symptomatic care is appropriate for most patients, and systemic corticosteroids are not routinely recommended because of limited benefit and potential adverse effects.