Acute Bacterial Rhinosinusitis Clinical Pathway – Primary Care, Emergency Department and Inpatient – Symptom Management

Acute Bacterial Rhinosinusitis Clinical Pathway – Primary Care, Emergency Department and Inpatient

Symptom Management

  • All children with rhinosinusitis can benefit from symptom management
  • Oral decongestants are not effective for ABRS
  • Antihistamines may be helpful for underlying allergic rhinitis
Therapy Considerations Side Effects
Nasal Saline Spray Helpful for mucus clearance and
symptom relief		  
Nasal Corticosteroids May provide modest benefit for
symptom resolution		 Epistaxis
Oxymetazoline Intranasal
  • Not routinely recommended
  • Temporary relief of severe nasal congestion
  • Do not use for more than 3 consecutive days
  • Use with caution < 6 yrs
  • Not recommended for outpatient use < 2 yrs
  • Rebound congestion if used excessively
  • Rare case reports of hypertensive crisis, especially in children < 6 yrs