Rhinitis

Definition/Description

Rhinitis is inflammation of the mucous lining of the nose.

Red Flag Symptoms

Bleeding with nasal deformity or pain - refer

Illness Comments Drug Dose Duration of T+
Rhinosinusitis

Avoid antibiotics as 80% resolve in 14 days without, and they only offer marginal benefit after 7 days A+.

Only use for persistent symptoms and purulent discharge lasting at least 7 days or if severe symptoms,

or high risk of serious complications (e.g. immunocompromised, cystic fibrosis) A+.

 

Use adequate analgesia B+.

Caution patients on excessive or prolonged use of topical decongestants.

First line (where indicated)

 

Amoxicillin A+

Adult: 500mg TDS

Child: see BNF for children

 5 days

Second line/penicillin

allergic (where indicated)

 

CHILD: Clarithromycin

 

 

ADULT & CHILD over 12

years: Doxycycline

Dose by body weight – see

BNF for children

 

200 mg stat/100 mg OD

5 days A+

 

 

 

 

5 days A+

Chronic Rhinosinusitis

 

i.e. lasting >12weeks

  

ADULT

Clarithromycin with once daily topical nasal steroid spray (fluticasone or mometasone)

 250mg 6-8 weeks

 

Note: Doses are oral and for adults unless otherwise stated. Please refer to BNF for further information.

A+ = systematic review;

B+ = RCT or cohort study;

Guidelines on Management

Considerations

  1. Anosmia with blockage? polyps > Prescribe 20mg prednisolone EC once daily for 1 week then spray for 6 weeks, if no better refer
  2. Steroid spray to be prescribed for at least 2 months, as takes 4-6 weeks to reach maximal effect…advise patients to persevere otherwise compliance will be poor
  3. Constant unilateral obstruction probably anatomical so refer as most likely to benefit from surgery
  4. Recurrent unilateral sinus infection, consider a dental cause

Referral Criteria/Information

No Referral Criteria/Information Listed

Associated Policies

There are no associated policies.

Specialties

Ear, Nose and Throat Hull Ear, Nose and Throat East Riding

Places covered by

  • East Riding
  • Hull

Hospital Trusts

  • Hull University Teaching Hospitals
Author:
Date created: 08/07/2025, 15:13
Last modified: 15/07/2025, 10:54
Date of review: 7/7/25