Canadian guidelines for rhinosinusitis: practical tools for the busy clinician

See guidelines at: http://www.aacijournal.com/content/7/1/2 webciteThe first comprehensive Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) and chronic rhinosinusitis (CRS) have recently been co-published in Allergy Asthma Clin Immunol [1] and in J Otolaryngol Head Neck Surg [2]. Although rhinosinusitis guidelines have been issued by European and American medical societies over the last few years [3-6], and guidance for the Canadian environment has appeared [7,8], the current Canadian guidelines mark the first time that comprehensive guidelines covering both ABRS and CRS appear, with a focus on addressing issues specific to the Canadian healthcare environment.The term rhinosinusitis is used to denote inflammation of the sinus and nasal passages, which often occur simultaneously due to their close location and shared respiratory epithelium. Rhinosinusitis is common and increasing in prevalence worldwide. It is associated with a significant burden on healthcare services, quality of patients' lives, and lost patient productivity. The prevalence of acute rhinosinusitis increased from 11% (or 26 million) of American adults in 2006 [9] to nearly 13% (over 29 million) in 2009 [10]. Nearly 7 years ago, the economic burden of the cost of treatment was estimated at 6 billion dollars annually in the United States [11]. Clearly, as rhinosinusitis continues to affect more individuals, the impact on patient lives and total costs will also continue to rise.Because ABRS and CRS have different pathologies and thus management strategies, it is critical that clinicians understand these differences so appropriate treatment can be started. However, analysis of Canadian prescription data demonstrated nearly identical prescribing habits for patients with ABRS and for those with CRS [12], highlighting that differences in the treatment of these distinct conditions were not fully appreciated. The Canadian guidelines provide easy-to-read and practical recommenda