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Major Symptoms

ABRS. CRS. P facial P ain/pressure/fullness O nasal O bstruction D nasal purulence/discolored postnasal D ischarge S S mell disorder (hyposmia/anosmia). Major Symptoms. C facial C ongestion/fullness P facial P ain/pressure O nasal O bstruction

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Major Symptoms

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  1. ABRS CRS P facial Pain/pressure/fullness O nasal Obstruction D nasal purulence/discolored postnasal Discharge SSmell disorder (hyposmia/anosmia) Major Symptoms C facial Congestion/fullness P facial Pain/pressure O nasal Obstruction D purulent nasal Drainage SSmell disorder (hyposmia/anosmia) ≥2 PODS, one of which must be O or D, present for >7 days without improvement. Diagnosis ≥2 CPODS + ≥1 objective finding (endoscopy/CT), present for 8-12 weeks. Determine CRSsNP vs CRSwNP. Mild Moderate Severe Mild Moderate Severe* Severity CRSsNP CRSwNP -INCS. -If no response within 72 hours, consider antibiotics. -INCS. -Antibiotics: 1st line Amoxicillin. TMP/SMX or macrolide for β- lactam allergy. 2nd line Amoxicillin/clavulanic acid combination or fluoroquinolone for risk of resistance, risk of complications, or 1st-line failure. Treatment -INCS. -Antibiotics (2nd line). -Consider: short course oral steroids, saline irrigation, specialist assessment. -If no response in 4 weeks, refer for surgical evaluation. -INCS. -Short course oral steroids. -Antibiotic if symptoms of infection. -Consider: allergy testing, leukotriene receptor antagonist, specialty referral. -If no response in 2-4 months, refer to surgeon. *Severe symptoms of CRS require immediate referral.

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