Revised Adult Sinusitis Guidelines Highlight Patient Education and Shared Decision-Making

The American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) has released an updated Clinical Practice Guideline (CPG) concerning adult sinusitis, aiming to improve quality of care through evidence-based strategies. Published today in Otolaryngology–Head and Neck Surgery, this comprehensive guideline offers practical recommendations designed to optimize management and outcomes for adults suffering from sinusitis.

Sinusitis remains a common condition, affecting approximately one in eight adults in the United States annually, leading to over 30 million diagnoses each year. The economic burden is significant, with direct treatment costs exceeding $11 billion, complemented by indirect costs like lost productivity and reduced quality of life, estimated between $12 to $20 billion.

Key updates in the guideline include a reinforced emphasis on 'watchful waiting' as the initial management for most bacterial sinus infections. This approach recognizes that many cases resolve without antibiotics, aligning with efforts to reduce unnecessary antimicrobial use. The guideline delineates clearer criteria for when antibiotics are warranted, suggesting narrow-spectrum antibiotics as first-line therapy when needed. Additionally, it introduces new insights into advanced treatments, such as biologics, especially for cases involving chronic sinusitis with nasal polyps.

Importantly, the guideline underscores that not all sinus symptoms necessitate antibiotics and promotes symptomatic treatments like nasal saline rinses and steroid sprays for relief. Patients are encouraged to engage in open dialogues with healthcare providers to choose personalized treatment plans.

This update is informed by a robust review of 14 guidelines, 194 systematic reviews, and 133 randomized controlled trials, reflecting a multidisciplinary effort involving otolaryngologists, infectious disease specialists, family medicine practitioners, allergists, immunologists, advanced practice nurses, patient advocates, and guideline developers.

Given that sinusitis accounts for a significant proportion of antibiotic prescriptions—about one in five adult antibiotic courses—this guideline serves as a vital tool to curb unnecessary antibiotic use, combat antibiotic resistance, and enhance patient care. The 14 key action statements focus on conservative treatments, objective diagnosis for chronic cases, and tailored therapy based on individual patient factors.

For more details, the full guideline can be accessed through the DOI: 10.1002/ohn.1344.

Source: https://medicalxpress.com/news/2025-07-adult-sinusitis-guidelines-emphasize-patient.html