Best Sinusitis Treatment Recommendations for
nonantimicrobial therapy

Intranasal steroids have not been conclusively shown
to be of benefit in cases of acute sinusitis. One meta-
analysis of 4 double-blind, placebo-controlled trials
of intranasal corticosteroid treatment in acute
rhinosinusitis supports its use as monotherapy or as
an adjuvant therapy to antibiotics.[35] However, a
recent randomized, controlled trial of antibiotics and
intranasal steroid showed no treatment benefit of
intranasal steroids, either alone or with antibiotics.
[36]

No available data suggest that antihistamines are
beneficial in acute sinusitis. In fact, antihistamines
may cause harm by drying mucous membranes and
decreasing clearance of secretions. Antihistamines are
beneficial for reducing ostiomeatal obstruction in
patients with allergies and acute sinusitis; however,
they are not recommended for routine use for patients

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