Establishing an accurate diagnosis of bacterial sinusitis is challenging but critical, because viral rhinosinusitis is at least 20 to 200 times more common than bacterial infection of the sinuses. Strict criteria for clinical diagnosis that require either prolonged and persistent symptoms or an acute severe presentation are supported with published evidence.
Acute Sinusitis—Principles of Judicious Use of Antimicrobial Agents
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Katherine L. O'Brien, Scott F. Dowell, Benjamin Schwartz, S. Michael Marcy, William R. Phillips, Michael A. Gerber; Acute Sinusitis—Principles of Judicious Use of Antimicrobial Agents. Pediatrics January 1998; 101 (Supplement_1): 174–177. 10.1542/peds.101.S1.174
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