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Physician adherence to acute rhinosinusitis antibiotic treatment guidelines
  1. Esther Levi1,
  2. Ohad Ronen1,2
  1. 1Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
  2. 2Department of Otolaryngology–Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
  1. Correspondence to Dr Ohad Ronen, Department of Otolaryngology–Head and Neck Surgery, Galilee Medical Center, Nahariya 2210001, Israel; ohadr{at}


Antibiotic treatment guidelines promote proper diagnosis and treatment and optimize antibiotic treatment, minimizing both antimicrobial resistance to antibiotics and financial expenditure. This study aimed to investigate whether community physicians and emergency department (ED) physicians diagnose and treat acute rhinosinusitis according to accepted guidelines. This was a retrospective study of medical records and referrer letters of patients admitted to the medical center between 2014 and 2015. Physician adherence to antibiotic guidelines regarding indication, type and duration of treatment was assessed. Overall, the study included 84 patients diagnosed with acute rhinosinusitis and admitted to the ED. Fewer than 20% of doctors treating patients with rhinosinusitis at our institution followed the current recommended guidelines. In most cases, the type of treatment administered by ED physicians and by community physicians complied with the guidelines (90% and 96%, respectively, p=0.564). The duration of treatment prescribed by the ED physicians aligned with the guidelines in 37.7% of the cases. There was insufficient compliance with acute rhinosinusitis treatment guidelines among all treating physicians in this study, which was characterized by excessive antibiotic treatment. Therefore, ways to increase understanding and adherence to clinical guidelines, and to provide optimal settings in the clinics to carry out the guidelines should be investigated.

  • bacterial infections
  • decision making
  • disease management
  • paranasal sinuses

Data availability statement

Deidentified participant data are available upon reasonable request from the corresponding author.

Statistics from

Data availability statement

Deidentified participant data are available upon reasonable request from the corresponding author.

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  • Contributors EL: substantial contributions to the acquisition and analysis. OR: substantial contributions to the conception or design of the work. EL, OR: substantial contributions to the interpretation of data for the work, drafting the work or revising it critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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