For acute sinusitis, antibiotics should not be started until at least how many days have passed since onset?

For acute sinusitis, antibiotics should not be started until at least how many days have passed since onset?

• A. 3 days
• B. 10 days
• C. 14 days
• D. 7 days

Answer: (D)

Acute sinusitis that is uncomplicated is usually self-limited, so antibiotics aren’t started right away. The best approach is watchful waiting for about seven days from onset to see if symptoms improve on their own. This window lets viral infections run their course while still keeping antibiotics available if the illness proves persistent or worsens. If symptoms are severe from the start, or if they persist beyond about seven days without improvement or worsen after an initial improvement, antibiotics should be started. The other timeframes aren’t used as the initial threshold: three days is too short to distinguish a viral illness from a bacterial one, while ten or fourteen days represent later points when management has already indicated a change in strategy.

Acute sinusitis that is uncomplicated is usually self-limited, so antibiotics aren’t started right away. The best approach is watchful waiting for about seven days from onset to see if symptoms improve on their own. This window lets viral infections run their course while still keeping antibiotics available if the illness proves persistent or worsens.

If symptoms are severe from the start, or if they persist beyond about seven days without improvement or worsen after an initial improvement, antibiotics should be started. The other timeframes aren’t used as the initial threshold: three days is too short to distinguish a viral illness from a bacterial one, while ten or fourteen days represent later points when management has already indicated a change in strategy.