What is the preferred treatment for acute bacterial sinusitis in children?

The preferred treatment for acute bacterial sinusitis in children is oral antibiotics. This is because acute bacterial sinusitis typically follows a viral upper respiratory infection and can lead to bacterial superinfection. When symptoms persist beyond 10 days or worsen after an initial improvement, antibiotic therapy becomes necessary to effectively combat the bacterial infection.

Administering oral antibiotics helps to eliminate the bacterial pathogens responsible for the sinusitis, thus alleviating symptoms and preventing complications. It's important to select an appropriate antibiotic regimen based on common pathogens known to cause sinusitis in children, such as Streptococcus pneumoniae and Haemophilus influenzae.

While intranasal steroids can be beneficial for reducing inflammation, their primary role is more relevant in chronic sinusitis or allergic rhinitis rather than in the acute bacterial phase. Oral antihistamines may help alleviate allergy symptoms but do not address the bacterial infection. Symptomatic treatment alone, which may include decongestants and pain relievers, does not resolve the underlying bacterial cause and is less effective if there is a clear bacterial infection present. Therefore, oral antibiotics are the most suitable course of action for managing acute bacterial sinusitis in children.