sinusitis 8

Handling
Acute sinusitis
In the acute sinusitis medicament's therapy is conducted during the 10-14 days of antibiotics, but can be extended until all symptoms disappear. Type amoxixilin, ampicillin, either erythromycin, sefaklor monohidrat, asetil sefuroksim, trimetropim-sulfametoksazol, amoxixilin-klavulanat acid, and clarithromycin (Mansjoer, 2001). Amoxixilin clavulanat (Augmentin) for 10-14 days is also the first choice of therapy for acute sinusitis without complications. Additional clavulanat (beta laktamase resistor) provides the perfect protection for H influenza and M catarrhalis, which is the lack of amoxixilin. In the areas with high resistant S pneumonia, amoxixilin the highest dose (80-90 mg / kg / dose and a maximum of 3 g / dose). This dose is effective for S pneumonia because resistance is associated with changes in protein association with penicillin (Radojicic, 2004).
Decongestant given to make the sinus drainage, this can be provided in a systemic and topical. On the topical must be restricted for 5 days to avoid the occurrence of rhinitis medicament's. Decongestant systemic frequently used only 2 types namely pseudoefedrin and fenilpropanilamin. Side effects are central nervous system stimulation and cardiovascular, and increased blood pressure in patients with hypertension is labile (Mansjoer, 2001).
Antihistamine on purulent acute sinusitis is not recommended, because it is a disease and can cause infection secret become thick and obstruct sinus drainage. Analgesic can be painful to remove. Mukolitik to dilute secret, improve workplace silia, fibrin and stimulates solutions. Intranasal delivery of steroid necessary to decrease the edema in the area of complex osteomeatal, especially when fused by allergy (Mansjoer, 2001).

Sinusitis chronicles
Medical therapy that is needed is broad spectrum antibiotics and Topical intranasal steroid. Therapy should be discontinued 4 to 6 weeks (Radojicic, 2004).
Drainage repairs and cleaning secret can be done pungsi or antrostomi and irrigation for sinusitis maxilla. While for etmoid sinusitis, frontal, and sfenoid washing can be done Proetz. Radical therapy is done with the mucosa that patologik sinus drainage and make the exposure. For sinus maxilla conducted Caldwell-Luc operation, while for the ethmoid sinus ethmoidektomi made of intranasal or ekstranasal. In the frontal sinusitis be either intranasal or ekstranasal (operating Killian) (Mansjoer, 2001). Procedure Caldwell-Luc operation is epitel sinus cavity maksilaris lifted entirely and at the end of the procedure is done antrostomi for drainage. Satisfactory result because the membrane mucosa pain was replaced by normal or mucosa filled with scar slow network (Adams, 1997).

Sinusitis fungus infection
Choice of therapy for sinusitis infection with a group of fungi that occur sinusitis acute sinusitis and slow fulminate is to move with surgical therapy and anti-fungus mushrooms in intravenous. While the fungus mycetoma sinusitis is not recommended the provision of anti-fungus (Alexandria, 2008).