Wel of geen antibiotica voor acute rinosinusitis: Het pleit nog niet beslecht

Antibiotics have little effect on acute rhinosinusitis in primary care. This was recently confirmed by a meta-analysis with individual patient data. These findings do not represent the final decision concerning the treatment of acute rhinosinusitis in primary care. In 1996 it was shown that antibiotic treatment had a considerable effect on acute rhinosinusitis diagnosed by CT scan in primary care. Although CT-scan will never become a diagnostic tool in daily practice, this study showed that there may be a subgroup of patients with acute rhinosinusitis that does benefit from antibiotic treatment. A return to diagnostic research in a large group of patients should be the next step to find this subgroup. In order to develop a diagnostic model, CT scans, sinus puncture, C-reactive protein and procalcitonin measurements and bacterial cultures should be performed and data on clinical signs and symptoms should be collected.