Are antibiotics indicated for acute sinusitis?

BACKGROUND Acute rhinosinusitis is a very common illness that is associated with physical, functional, and emotional impairments and significant treatment costs. Rhinosinusitis is defined as symptomatic inflammation of the sinuses and nasal cavity. Acute rhinosinusitis is classified as illness or symptoms for <4 weeks. It is typically a self-limiting disease; however, there are potential rare serious complications of acute infection, including meningitis, orbital infection, and brain abscesses. Due to increasing concerns with antibiotic resistance, and the common confusion of viral rhinosinusitis with bacterial infection, it is important to consider the indications of antibiotic treatment for acute rhinosinusitis. Currently, antibiotics are prescribed very frequently in patients with acute sinusitis; acute rhinosinusitis is the fifth most common condition for which an antibiotic is prescribed in the United States. The management of acute rhinosinusitis in adults has been a controversial topic for many years due to questions about overprescribing of antibiotics as well as inappropriate radiographic imaging and testing.