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Diagnosing Acute Bacterial Rhinosinusitis—Reply
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In reply
The rationale of our trial1 was to include adult patients with suspected ABRS based on clinical information because in general practice the decision to use antibiotics is usually based on this information. In reply to Dr Weinberg's questions: our inclusion criteria—a history of repeated purulent nasal discharge and maxillary or frontal unilateral or bilateral pain—are symptoms most likely associated with ABRS.2 Patients could present other common symptoms of URTIs, but these were not part of our inclusion criteria. Body temperature was measured in all patients at baseline, but body temperature is a poor predictor of ABRS. No further testing was done to identify patients with allergic rhinitis. In Switzerland, however, this condition is rare in winter and in early spring.
The criterion of a minimum of 7 days of symptom duration for antibiotic treatment in acute rhinosinusitis gained general acceptance with wide dissemination from about 2000 on. It . . . [Full Text of this Article]
Heiner C. Bucher, MD;
James Young, PhD;
Peter Tschudi, MD
Basel, Switzerland
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