In the past, the first thing that a doctor would do if a child was feared to have sinusitis is to prescribe antibiotics. The antibiotics would help to get rid of the infection so that the child could get better faster. In recent years, children have not been recovering from their infection as quickly. This has less to do with sinusitis becoming more threatening and more to do with the body reacting less to antibiotics.

New Regulations from the AAP

The American Academy of Pediatrics (AAP) has determined that it is necessary for doctors to be given the opportunity w patients to get better without treatment. It is now allowed for doctors to use a “watch-and-wait” approach to treatment. In this method, doctors will hold off on prescribing any medication and watch the patient for a few days. If the symptoms persist, get worse or do not improve, than antibiotics can be prescribed.

The biggest reason for the change is the realization that the intensity of the antibiotics that are being prescribed has gone up exponentially in the past few decades. More doctors have been taking the approach of taking it safe by prescribing antibiotics at the first sign of a problem. This has been having more of a negative, rather than a positive effect.

Doctors are given the option to prescribe medicine right away or wait to see what will happen with the medicine they are prescribing. The majority of doctors that will wait and see, will determine this course of action based upon the level of severity of the individual case. Those who seem extremely ill may still receive treatment even with the new regulations in place.

The Trouble with the Cold

One of the biggest problems that doctors have been encountering in the past is the cold. The average cold has many symptoms that act almost exactly like a sinus infection. This leads doctors to prescribe antibiotics even in cases where none is needed, nor would it be beneficial. The overall effect of this course of action is that children are taking more antibiotics than ever in history.

The new regulation from the AAP will allow doctors the opportunity to see exactly what they are dealing with before taking additional action. The most recent data on the subject shows that only 7 percent of children seeing a doctor for a respiratory issue have acute sinusitis.

Symptoms to Watch For

The AAP report gave specific criteria to help with diagnosing acute sinusitis. Here are the symptoms that they identified for doctors: nasal discharge or a persistent cough lasting 10 or more days, initial improvement followed by a new or worsening condition like fever, daytime cough or nasal discharge, and a three day period of nasal discharge and a severe fever of at least 102 degrees.

If these symptoms are found in a child, it is likely that you are dealing with a case of sinusitis. The use of antibiotics, amoxicillin being the most common, is necessary at this point.

X-Rays and other imaging techniques have been discouraged in uncomplicated cases. Even in complicated cases, the AAP recommends only using scans like MRI and CT to determine the severity of the illness. The point is to further protect the young patients when something may or may not be wrong.

Parents Still Have Say

Even though the new regulations regarding sinusitis ask doctors to err on the side of caution, parents are still given the ability to request immediate treatment. In these cases, doctors are encouraged to inform parents of the dangers of overprescribing antibiotics, but to ultimately leave the decision in the hands of the parent.

About Author : Dr. Michael Barakate is a paediatric and adult otolaryngologist located in Sydney, Australia. For more information on ENT surgery and ENT disorders, visit ENT-Surgery.com.au.
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