This webinar covers some specialist prescribing advice around chronic rhinosinusitis. Please note long-term antibiotics in chronic rhinosinusitis should generally be avoided in primary care due to the low quality of evidence and potential of increased risks of cardiovascular events with some macrolides. NICE CKS on chronic sinusitis also advises to seek specialist advice before prescribing long-term antibiotics, as the evidence for this approach is limited. Local antimicrobial guidance can be found here.

The NI formulary team suggest If a specialist team wishes to put an individual patient on clarithromycin this should be done after the initiating team have discussed the risks and benefits with the patient, including antibiotic resistance, and risk having assessed the risk of adverse effects (such as cardiac effects including QT prolongation) and medication interactions where applicable.

 Further reading – RCS Comissioning Guide for Chronic Rhinosinusitis 

Dr David Dick

SpR ENT

Dr Patrick Stirling

GPNI / NIGPC / GP Partner