What is the mainstay of treatment for uncomplicated acute bacterial sinusitis?

• A. Decongestants for all patients.
• B. Antibiotics, if symptoms last longer than 10 days or worsen.
• C. Long-term corticosteroid use.
• D. Immediate surgical intervention.

Answer: (B)

The key idea here is using antibiotics selectively based on how the illness progresses. In uncomplicated acute bacterial sinusitis, many cases are self-limited or viral, so immediate antibiotics aren’t required. Antibiotics become the main treatment when there’s evidence that a bacterial infection is unlikely to resolve on its own: specifically, if symptoms persist for more than about 10 days without improvement or if they worsen at any point. This threshold helps avoid unnecessary antibiotic use while still treating infections that are unlikely to improve promptly.

Decongestants for everyone aren’t the mainstay because they don’t treat the bacterial infection and can miss the opportunity to prevent complications. Long-term corticosteroids aren’t appropriate for this condition, and immediate surgical intervention isn’t indicated for uncomplicated cases.