ACUTE RHINOSINUSITIS: EUROPEAN STANDART FOR EXAMINATION AND TREATMENT

Acute rhinosinusitis (ARS) in adults is a sudden occurrence of two or more of the symptoms of which one is nasal discharge, facial pain, unilateral or symmetrically on both sides, reduction or loss of smell with the proviso that the symptoms persist for at least 12 weeks. Algorithms for the examination and treatment offered in the latest edition of the European conciliation document sinusitis and nasal polyposis (EPOS) 2012 can be used as the basis of patient care protocols in national medical practice.ARS can be caused by viral, bacterial or fungal infections. The main pathogens are: Streptococcus pneumoniae (44%), Haemophilus influenzae (27%), Moraxella catarrhalis (16%), â-hemolytic Streptococcus (7%), BS. Pyogenes (3%), H. Parainfluenzae (2%), S. Aureus (1%). Algorithms examination of ARS includes: medical history and complaints, visual examination of the upper respiratory tract, palpation of the front walls of the paranasal sinuses, optic rhinoscopy, analysis of blood, x-ray examination. Treatment is designed for 7-10 days and includes: antibiotics, topical decongestants, topical corticosteroids, saline solutions, antihistamines, mucolytics, anti-inflammatory, sinus puncture. The modern concept of antibiotic therapy patients ? SMART ? use. International Association of IDSA and EPOS recommend: Amoxicillin/clavulanate ? first-line antibiotics, second- or third-generation cephalosporins and macrolide antibiotic ? second-line antibiotics, antibiotic of reserves ? respiratory fluoroquinolones.