When would you consider initiating antibiotic sinus rinses for recurrent sinus infections, assuming no other underlying pathology and normal infunction?  

Antibiotic sinus rinses are a great alternative to antibiotics by mouth. If indicated, I would favor the rinses after sinus surgery when there is better access to the sinuses. One commonly used preparation is Bactroban or bacitracin in a 45 ml Ocean nasal spray bottle.