What is the recommended treatment for bacterial sinusitis?

The recommended treatment for bacterial sinusitis is amoxicillin-clavulanate. This combination antibiotic is particularly effective because it covers a broad range of bacteria commonly responsible for sinus infections, including both typical pathogens like Streptococcus pneumoniae and Haemophilus influenzae, as well as resistant strains.

Amoxicillin itself is effective against many of the bacteria involved, but the addition of clavulanate helps inhibit beta-lactamase enzymes that some strains produce, enhancing the overall efficacy of the treatment. Amoxicillin-clavulanate is usually the first-line therapy for moderate to severe cases of bacterial sinusitis, especially when symptoms are severe, prolonged, or if there is a history of antibiotic resistance.

In contrast, options like ciprofloxacin and cephalexin do not have the optimal coverage for the common pathogens associated with sinusitis. Azithromycin, while being a macrolide antibiotic that can treat some respiratory tract infections, is not typically the first choice due to concerns regarding effectiveness against the pathogens most commonly involved in sinusitis and emerging resistance patterns.