Which types of patients do you treat with prolonged antibiotics before obtaining a CT sinus?

If the patient has had symptoms of chronic rhinosinusitis for more than 7 days I would give a 10-day course of Levoquin. The symptoms I look for include purulent post-nasal drainage, nasal congestion, and lethargy. If the patient does not respond in 203 days, I would obtain a sinus CT.

If the patient has symptoms suggestive of acute sinusitis (less than 4 - 12 weeks), I will treat with augmentin 875 mg X 2 per day for 10 days with 1 refill for another 10 days.

Refill is to be taken if there is a recurrence of symptoms after 10 days of antibiotic treatment or if symptoms getting better but not quite there with 10 days of treatment.

If the patient has symptoms suggestive of chronic sinusitis (more than 12 weeks), I treat them with Levaquin 500 mg for 3 - 4 weeks.

I order limited...