Chronic Rhinosinusitis (CRS) is increasingly recognized as an inflammatory rather than purely infectious condition, calling into question the routine prescription of antibiotics. According to updated clinical guidelines, antibiotics should not be prescribed to adults with CRS unless significant or persistent purulent nasal discharge is observed. This recommendation, backed by limited but consistent RCTs, highlights the risks of unnecessary antibiotic use, including side effects, antimicrobial resistance, and increased healthcare costs.
Despite their traditional use, short-term nonmacrolide antibiotics show only marginal benefits in select CRS cases, while the role of macrolides remains controversial due to their potential anti-inflammatory effects. ENT specialists must use clinical judgment and prioritize evidence-based care, reserving antibiotics for cases with clear bacterial…
