Rhinosinusitis (congested or runny nose) Management

• Antibiotics are not needed 98-99.5% of the time

• Most cases usually resolves in 7-10 days without treatment

• Symptomatic management gold standard

  • ​Saline irrigation twice daily (Neilmed Sinus Rinse)

  • PLUS steroid nasal spray (mometasone nasal spray – “Nasonex/Sensease”)

  • PLUS short term decongestant such as pseudoephedrine/phenylephrine

Acute viral rhinosinusitis (the common cold) is the most common form of acute rhinosinusitis. It is estimated that only 0.5% to 2% of respiratory tract infections are complicated by bacterial infection. Antibiotics are therefore not useful for most acute rhinosinusitis cases.

Uncomplicated acute viral rhinosinusitis resolves in 7 to 10 days without treatment, 80% of bacterial sinusitis cases resolve in 2 weeks.

To use a nasal spray effectively and safely:

• Clear the nasal passages first; using a saline nasal spray may be helpful.

• Shake the bottle and follow the manufacturer's advice (package insert) about priming if needed.

• Bend your neck forward and look down.

• For intranasal corticosteroids, use your right hand for the left nostril and vice versa. Put the nozzle just inside the nose aiming towards the outer wall.

• Change hands and repeat for the other side.

• Avoid sniffing too hard or the liquid is likely to go straight down the throat.