Antibiotic only if: Symptoms 10 days or more without improvement, severe (fever 39 °C and purulent discharge 3 d), or worse after initial improvement (NCDC-ICMR 2025; AAO-HNS 2025)
Refer the same day: Eye swelling, double vision, reduced vision, severe headache or neck stiffness (AAO-HNS 2025)
Investigations
First visit
No tests needed — Acute sinusitis is a clinical diagnosis; X-ray PNS is not recommended.
Only if indicated
CT PNS — Suspected complication (eye swelling, double vision, severe headache) or no response after 14 days.
Nasal endoscopy with swab culture / KOH — Non-resolving disease; fungal sinusitis in diabetics.
Blood glucose — Recurrent or severe sinusitis, or black crusts (mucormycosis).
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.