GPs can finally stop asking about the colour of nasal discharge when treating kids with acute sinusitis, with results from a US cohort study confirming it has no impact on the effectiveness of antibiotic treatment.

While Australian and international sinusitis guidelines include purulent nasal discharge in diagnostic criteria, US paediatricians suggest it “should not influence therapeutic decisions”.

Their randomised trial included 510 children, aged 2-11, with acute sinusitis but no history of allergic rhinitis or asthma who received either oral amoxicillin (90mg/kg/day) and clavulanate (6.4mg/kg/day) or placebo.

Two-thirds of the cohort had coloured nasal discharge, and 71% returned positive nasopharyngeal swabs for Streptococcus pneumoniae, Haemophilus influenzae or Moraxella catarrhalis, but there was a “weak” correlation between the two variables.