Pharmacotherapy of acute sinusitis in children

The pharmacotherapeutic options for acute sinusitis in children are reviewe d. Acute sinusitis occurs more frequently in children than in adults. The diag nosis is based primarily on clinical signs and symptoms. Streptococcus pneu moniae, Haemophilus influenzae, and Moraxella catarrhalis are the organisms most frequently implicated. A variety of antimicrobials have FDA-approved labeling for use in the treatment of sinusitis. In randomized, controlled c linical trials identified in a MEDLINE search for the period from 1966 to 1 999, amoxicillin had efficacy similar to that of amoxicillin-clavulanate, a zithromycin cefuroxime, and clarithromycin in treating acute sinusitis in;c hildren. Azithromycin was effective as a three-day course of treatment. Amo xicillin and cefuroxime are better tolerated than most antibiotics; azithro mycin and clarithromycin are also well tolerated. Amoxicillin-clavulanate t ends to cause more gastrointestinal symptoms than amoxicillin and is more e xpensive. Azithromycin is more expensive than amoxicillin but less expensiv e than other broad-spectrum antimicrobials. Amoxicillin remains the drug of first choice for treating acute sinusitis i n children. It has been found to be as effective as other broad-spectrum ag ents, better tolerated, and less expensive.