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IV Antibiotics & Chronic Sinusitis Increasing information indicates that intravenous antibiotics play a significant role in improving the severe sinusitis and can be used in the patient who is not

For example, a person with mild CRS may complain of chest discomfort that never goes away. The first thing someone with CRS usually does is consult a cardiologist. Typically, the evaluation includes auscultation, chest angiography, and, sometimes, CT angiography for an ultrasound examination which is the mainstay of CRS evaluation. Often, these tests show no cause, so they are never used for management. In addition, no imaging studies are routinely performed, so the patient is left with the limited diagnostic tool of the doctor's “expert” opinion. At that point the patient might opt for a conservative modality of treatment — this is often done before a surgical consultation or an endoscopy. A surgeon who is experienced in CRS and who has been involved in numerous CRS cases in this setting is likely to recommend a multidisciplinary approach to management with a comprehensive surgical approach as an alternative approach. For example, surgery for CRS consists of at least two surgical areas: the anterior surgical site (the sinus) and the posterior surgical site (the lower extremities). For patients who may not have a good understanding of what surgery looks like for a right sinusitis (anterior surgical approach) or left sinusitis (posterior surgical approach), the surgeon may refer the patient to a radiologist. The surgeon might also refer the patient to an ear/ear nose and throat specialist, who might be able to review the imaging and perform a multidisciplinary evaluation with the patient's surgeon, an ear, nose, and throat pediatrician, and an otolaryngologies for additional imaging studies. This is a complete review of the patient's medical history, including family history, imaging findings including CT angiography, and a complete physical exam. An important note regarding surgery for people with chronic sinusitis: There is a consensus among practitioners and researchers on the use of low-dose, short-duration intravenous antibiotics for the management of people with chronic sinusitis and is therefore generally accepted by practice groups and patients. Therefore, we recommend this approach by default; however, we recognize the need for multidisciplinary, comprehensive surgical therapy if the chronic sinusitis or the right or left lower extremity becomes complicated by chronic sinusitis or if there is a significant risk that the sinus is inflamed and will heal of it on its own.

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