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This is an update of the original evidence report, Diagnosis and Treatment of Acute Bacterial Rhinosinusitis, published in March 1999 by the Agency for Health Care Policy and Research. Our objective is to summarize and analyze comparative studies on the antibiotic efficacies in the treatment of acute bacterial sinusitis. The research questions in this evidence report are: 1. Given a clinical diagnosis of acute bacterial rhinosinusitis, what are the comparative efficacies of the antibiotics in resolving symptoms and preventing complications or recurrence? 1a. Is there evidence that duration of antibiotic treatment in acute bacterial rhinosinusitis affects efficacy? 2. What adverse effects are reported for antibiotics used for acute bacterial rhinosinusitis? 3. How does the introduction of the pneumococcal vaccine affect the resistance patterns of pneumococcus and the treatment decisions in acute bacterial rhinosinusitis? Acute bacterial rhinosinusitis is defined by clinical signs and symptoms of inflammation of sinuses and nasal passages of less than 30 days. Cure, improvement, and treatment failure definitions are based on the original reports. Studies of subjects with either acute sinusitis or acute exacerbation of chronic sinusitis were included. Studies of sinusitis with complications, those that exclusively evaluated chronic sinusitis and studies of acute sinusitis along with other respiratory infections were excluded.

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