Researchers from Canada have reviewed available data on the treatment of adult chronic sinusitis in a systematic review published in the Journal of the American Medical Association. Chronic sinusitis is defined by persistent symptomatic inflammation of the sinonasal cavities lasting longer than 3 months. Previously thought to be entirely infectious in etiology, chronic sinusitis is now recognized as an inflammatory disease of the upper airways analogous to asthma in the lower airways. Evidence supports daily high-volume saline irrigation along with topical corticosteroids as first-line therapy (A-1 grade). A short course of systemic corticosteroids, short-course doxycycline (3 weeks), or a leukotriene antagonist may be considered in patients with nasal polyps. Three months of macrolide antibiotics may be considered for patients without polyps (JAMA 2015;314:926-939).
Evidence supports daily high-volume saline irrigation along with topical corticosteroids as first-line therapy.
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