e-TABLE 94.3 SIGNS AND SYMPTOMS OF ACUTE BACTERIAL SINUSITIS Signs/symptoms Frequency Nasal discharge Cough >90% 75% Fever Headache/facial pain Facial swelling Periorbital or orbital edema 50% Rarely seen in young children 10–20% with maxillary sinusitis 20–40% with ethmoid sinusitis e-TABLE 94.4 CLINICAL CRITERIA FOR THE DIAGNOSIS OF ACUTE BACTERIAL SINUSITIS IN CHILDREN TO 18 YEARS OF AGE Persistent nasal drainage and/or daytime cough lasting more than 10 days without improvement or Worsening clinical course (nasal drainage, daytime cough, or fever) after initial clinical improvement or Purulent nasal drainage for at least consecutive days and fever ≥102.2°F (39°C) From Wald ER, Applegate KE, Bordley C, et al Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged to 18 years Pediatrics 2013;132(1):e262–e280 e-TABLE 94.5 TREATMENT OF ACUTE BACTERIAL SINUSITIS Scenario Antibiotic Dose a Uncomplicated, Amoxicillin antibiotic resistance not suspected 80–90 mg/kg/day (maximum: g/dose) Moderate to severe illness, daycare attendees, children recently treated with amoxicillin Amoxicillinclavulanate 80–90 mg/kg/day of amoxicillin component (maximum: g/dose) Penicillin-allergic patients Second- or thirdgeneration cephalosporin Cefuroxime 15 mg/kg bid (maximum: g/day) for preadolescents; 250 mg bid for adolescents Cefdinir 14 mg/kg daily (maximum: 600 mg/day) Cefpodoxime 10 mg/kg bid (maximum: 200 mg/dose) Cefixime mg/kg/day (maximum: 400 mg/day) Clindamycin 10 mg/kg tid (maximum: 600 mg/dose) PenicillinCefixime + anaphylactic clindamycin patients