Treatment of Adult Patients with Acute Bacterial Rhinosinusitis: Official Practice Guideline of the Infectious Diseases and Tropical Medicine Research Center Advisory Committee

AuthorSoheil Roshanzamirien
AuthorAmirali Jahanshahien
AuthorDavood Yadegariniaen
AuthorMasoud Mardanien
AuthorShervin Shokohien
AuthorAmir Rajabien
AuthorNima Dehghanen
AuthorPooya Vahedien
AuthorMohammad Hossein Ramezanien
AuthorIlad Alavi Darazamen
OrcidMasoud Mardani [0000-0001-6082-072X]en
OrcidShervin Shokohi [0000-0002-9611-2466]en
OrcidIlad Alavi Darazam [0000-0002-4440-335X]en
Issued Date2025-10-31en
AbstractContext: Acute bacterial rhinosinusitis (ABRS) is a significant public health concern, affecting approximately 15% of the population annually, with a higher prevalence among women. The bacterial etiology primarily includes Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Due to regional variations in bacterial resistance patterns, there is a critical need for localized and evidence-based guidelines for better management in Iranian patients. Evidence Acquisition: A multidisciplinary team reviewed literature from Iranian and international databases published between January 1990 and 2024. Studies included epidemiological data on ABRS prevalence, bacterial resistance patterns, and clinical outcomes. Results: First-line empirical antibiotic therapy for uncomplicated ABRS in Iran includes amoxicillin-clavulanate (500 mg/125 mg three times daily or 875 mg/125 mg twice daily). In cases with high antibiotic resistance, high-dose amoxicillin-clavulanate (2000 mg/125 mg extended-release tablets twice daily) is preferred. Respiratory fluoroquinolones (levofloxacin or moxifloxacin) are recommended for penicillin-allergic patients, with alternative options for non-type I hypersensitivity cases. Conclusions: The guideline standardizes the antimicrobial approach to ABRS in Iran, considering local resistance patterns and clinical evidence.en
DOIhttps://doi.org/10.5812/archcid-162500en
KeywordSinusitisen
KeywordRhinosinusitisen
KeywordPractice Guidelineen
KeywordIranen
PublisherBrieflandsen
TitleTreatment of Adult Patients with Acute Bacterial Rhinosinusitis: Official Practice Guideline of the Infectious Diseases and Tropical Medicine Research Center Advisory Committeeen
TypeReview Articleen

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