Warning

Advise paracetamol or ibuprofen for pain. Little evidence that nasal saline or nasal decongestants help, but people may want to try them.

Symptoms for 10 days or less: no antibiotic.

Symptoms with no improvement for more than 10 days: no antibiotic or back-up antibiotic depending on likelihood of bacterial cause. Consider high-dose nasal corticosteroid (if over 12 years).

Systemically very unwell or high risk of complications: immediate antibiotic.

Drug details

Drug

First choice:

Amoxicillin

Dosage

500mg

Duration

3 times a day 5 days

Child Dose

Drug

Penicillin allergy or alternative required:

Doxycycline

Dosage

200mg

Duration

on day 1 then 100mg once daily for 4 further days.

Use clarithromycin for 5 days in children under 12 with penicillin allergy.

Child Dose

Drug

OR (penicillin allergy in pregnancy)

Erythromycin

Dosage

250-500mg

Duration

4 times a day or 500-1000mg twice daily 5 days.

 

For persistent symptoms seek advice from ENT.

Editorial Information

Last reviewed: 18/05/2022

Next review date: 18/05/2025

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick, Heather Boyle.

Version: V1

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.

Document Id: June 2022