Rinossinusite Aguda - Saiba quando prescrever corretamente ATB

Acute Rhinosinusitis in Clinical Practice: When It's Viral, When It's Bacterial, and How to Manage It Without Overreacting Facial pain that worsens when tilting the head, nasal obstruction, and thick discharge are very common complaints in the emergency room. But is it necessary to order a sinus x-ray? And are antibiotics really necessary in most cases? In this video, I explain the pathophysiology in a didactic way and show a safe step-by-step process to differentiate viral from bacterial conditions and define the best course of action. What you will learn (on-call checklist): ✔ Essential pathophysiology: mucosal edema, ciliary dysfunction, and "pressure cooker" effect in the paranasal sinuses. ✔ Clinical diagnosis: when the history and physical examination are sufficient (and why sinus x-rays rarely change management). ✔ Signs of probable bacterial infection: high fever, intense facial pain, unilateral purulent rhinorrhea, and "double worsening" after initial improvement. ✔ Symptomatic management based on mechanism: NSAIDs (e.g., ibuprofen), nasal corticosteroids (e.g., budesonide), and nasal irrigation with 0.9% saline solution. ✔ Antibiotics: when to actually indicate them and main options (amoxicillin; amoxicillin/clavulanic acid; allergy alternatives) and typical duration. ✔ Common mistakes to avoid: early antibiotic administration without criteria and routine X-ray requests. ✔ Discharge and follow-up instructions: how to record warning signs and organize follow-up. ➡️ If this content helps you provide more confident care, subscribe to the channel, activate the bell, and leave your like. Comment on how you manage rhinosinusitis on your shift and if you usually prescribe antihistamines in any scenario. ⚠️ Content intended exclusively for physicians and medical students. Do not use this material for self-medication. Each case requires individualized clinical evaluation. #Rhinosinusitis #URTI #Otorhinolaryngology #MedicalClinic #MedicalEmergency #RationalUseOfAntibiotics #PhysicianInPractice #EmergencyMedicine