Pediatric Client with Acute Bacterial Sinusitis
Pediatric Client with Acute Bacterial Sinusitis
| List the clinical criteria that must be present to support this diagnosis in pediatric patients from newborn to 21 years of age. Categorize clinical signs and symptoms by: Persistent Symptoms, Severe Onset, or Worsening Symptoms.
|
List Criteria for Persistent Symptoms.
· 0–30 days without improvement · Nasal discharge · Daytime cough that worsens worse at night · Variable fever · Variable headache and facial pain
|
List Criteria for Severe Onset of Symptoms.
Severe · Purulent rhinorrhea · High fever that is above 39o C) · Purulent nasal discharge simultaneously for minimum of 3 to 4 days
|
List Criteria for Worsening Symptoms
· Cough or nasal discharge for five to six days · Increased nasal discharge · Increased coughing · Onset of new fever · Onset of severe headache
(Badr et al, 2016) |
| When would imaging studies be indicated?
|
Imaging for pediatric patients with cute sinusitis should be performed when the patient is suspected to having orbital complication or central nervous system complications (Pynnonen et al, 2015). | ||
| What is the recommended Antibiotic for Child with No Known Allergies?
Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).
|
Amoxicillin at 45 mg/kg/day in 2 doses
Duration of treatment: 10 days
(Badr et al, 2016)
|
||
| What is the second line Recommended Antibiotic for Child with allergy to PCN
Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).
|
50 mg/kg Ceftriaxone IV or IM
Duration of treatment: 10, 14, 21, 28 days Pediatric Client with Acute Bacterial Sinusitis
(American Academy of Family Physicians, 2014). |
||
| When is Referral indicated?
|
If the child is having systemic toxic effects, sinusitis complications, or is unable to take oral antibiotics
(Pynnonen et al, 2015). |
||
| What additional medications and or treatment strategies are recommended for treatment or symptomatic control
|
· Acetaminophen for pain, fever or discomfort control
· Intranasal corticosteroids · Gentle nasal irrigation |
||
| What is the treatment change in a child with worsening symptoms at 72 hours after initiation of antibiotic
|
Amoxicillin-clavulanate (Pynnonen et al, 2015). | ||
| When is outpatient 72 hour “observation” acceptable?
|
If there is no symptom worsening | ||
| What modifications would be needed for the following children:
Four-year-old who is otherwise healthy
|
Not indicated | ||
| Child with immune deficiency
|
Amoxicillin-clavulanate, 90mg/kg/day for 14 days
(American Academy of Family Physicians, 2014). Pediatric Client with Acute Bacterial Sinusitis |
||
| Child with two prior sinus infections
|
Surgical intervention might be indicated
(Pynnonen et al, 2015). |
||
| Child with cystic fibrosis
|
Endoscopic sinus surgery is recommended
ORDER A FREE -PAPER HERE |
||
| What other conditions would modify these treatment recommendations?
|
Allergic rhinitis, gastroesophageal reflux, and anatomical abnormalities (Badr et al, 2016) | ||
References
American Academy of Family Physicians. (2014). AAP Releases Guideline on Diagnosis and Management of Acute Bacterial Sinusitis in Children One to 18 Years of Age. Am Fam Physician. 89(8),676-681.
Badr D, Gaffin J & Wanda P. (2016). Pediatric Rhinosinusitis. Curr Treat Options Allergy. 3(3), 268–281.
Pynnonen M, Lynn S, Kern H, Novis S, Akkina S, Nahid K & Davis M. (2015). Diagnosis and treatment of acute sinusitis in the primary care setting: a retrospective cohort. Laryngoscope. 125(10), 2266–2272.
MN580assignmentjg (1)
Pediatric Client with Acute Bacterial Sinusitis
