Abstract
In 2001, American Academy of Pediatrics (AAP) has recommended that the diagnosis of acute bacterial sinusitis (ABS) in children ≦6 years of age is based on clinical criteria of persistent symptoms which are defined as daytime cough (which may be worse at night) and nasal discharge (of any quality) persisting for >10 days without evidence of improvement.
We recruited children with ABS ≦6 years of age who were diagnosed according to AAP 2001 guideline from March 2008 through February 2009 at our pediatric practice and prescribed amoxicillin (AMPC) with a dose of 80 mg/kg/day, 3 divided doses, for 3 days as the first-line antibiotic to manage ABS.
Only 16 children, the mean age 2.8±1.8 years, were diagnosed. The high dose AMPC was effective in 13 children (78.6%), who were completed the antibiotic treatment by added the same doses AMPC for 2 more days. The three treatment failure cases were changed antibiotic from AMPC to azithromycin (AZM) as the second-line antibiotic to eliminate possible causative pathogen, Haemophilus influenzae, which might be thought to be intracellular, biofilm forming or drug resistant. AZM was was effective in all three cases.
