2014 加拿大急性细菌性鼻窦炎指南.pdfVIP

Clinical Review Canadian guidelines for acute bacterial rhinosinusitis Clinical summary Alan Kaplan MD CCFP(EM) FCFP Abstract Objective To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Main message Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild and moderate EDITOR’S KEY POINTS cases, although the benefit might be modest. Use of INCSs plus • Rhinosinusitis is a common malady, afflicting antibiotics is reserved for patients who fail to respond to INCSs approximately 1 in 8 adults. Sinus symptoms are after 72 hours, an