What is the first-line drug of choice for treating acute sinusitis?

The first-line drug of choice for treating acute sinusitis is Augmentin (amoxicillin-clavulanate). This choice is recommended for a few key reasons.

First, Augmentin is effective against both typical bacteria that commonly cause acute sinusitis, such as Streptococcus pneumoniae and Haemophilus influenzae, as well as bacteria that might produce beta-lactamase, making them resistant to standard penicillins. The clavulanate component of Augmentin inhibits beta-lactamase, thereby enhancing the efficacy of amoxicillin.

Second, clinical guidelines recommend Augmentin based on its favorable balance of efficacy, safety, and the resistance patterns of organisms involved in sinusitis. It is particularly favored in cases where there is a higher probability of bacterial infection or in patients who have had symptoms persisting for more than 10 days, as well as in those with severe symptoms.

While other antibiotics might be used in specific situations, such as fluoroquinolones like ciprofloxacin or macrolides like azithromycin, they are not typically considered first-line due to concerns over resistance, side effects, and less favorable outcomes compared to Augmentin in treating acute sinusitis. Ampicillin, while