On the nose

Sinusitis, whether acute or chronic, affects a significant proportion of the Australian population, with females being affected more than males. It can cause substantial morbidity and affect quality of life. Individuals with particular disease states have a greater susceptibility to chronic sinus infections including those with Down syndrome, cystic fibrosis and hypertension. However, identifying the condition can sometimes be challenging as sinusitis shares several symptoms in common with allergic rhinitis which has been described as the most common disease in the developed world. Careful questioning and : discussion with patients can however delineate sinusitis from allergic rhinitis. Many cases of acute sinusitis will resolve with early self care and watchful waiting; however, a propor-tion will benefit from antibiotics. Patients will often prefer to prevent sinusitis where possible, and a number of strategies may assist. For those who smoke, cessation will frequently assist, while for those with underlying allergies, intranasal steroids or second generation antihistamines may assist. Pharmacists and their staff have an opportunity to contribute to increased quality of life in their patients with sinusitis.