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Review: diagnostic tests for bacterial rhinosinusitis have moderate accuracy; antibiotics reduce clinical failures

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 QUESTION: In symptomatic patients in primary care settings, what are the most effective diagnostic tests, antibiotics, and ancillary treatments for bacterial rhinosinusitis (paranasal sinus bacterial infection with symptoms for ≤4 wks)?

Data sources

Studies were identified by searching Medline (1966 to May 1998) with the terms sinusitis and sinus with upper respir: and infect: (using various endings) and EMBASE/Excerpta Medica; scanning lists of conference abstracts and bibliographies of relevant articles and studies; and contacting experts.

Study selection

All studies included adults or children who had had symptoms for ≤4 weeks. Diagnostic studies were selected if they compared the results of ≥2 tests, including clinical criteria, radiographs, ultrasonography, or sinus puncture. Randomised controlled trials were selected if they compared antibiotics with placebo or compared ≥2 antibiotics. …

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  • Source of funding: Agency for Health Care Policy and Research.

  • For correspondence: Dr J Lau, New England Medical Center, Division of Clinical Care Research, 750 Washington Street, Box 63, Boston, MA 02111, USA. Fax +1 617 636 8023.