Patient should be evaluated for more serious illness.

Signs that should raise caution are:

• Mental status changes
• Shortness of Breath/Respiratory Distress
• Visual changes
• Periorbital Edema
  

Symptoms indicating dermatitis include:

• Persistent symptoms for at least 5 days and less than 4 weeks
• purulent nasal discharge
• maxillary tooth or facial pain
• unilateral maxillary sinus tenderness
• headache
• otalgia
• cough
• eye pressure

Treatment:

General Measures:

•  increase fluids (non-caffeine and non-alcohol)
• steam inhalation
• saline irrigation of the nose
• decongestants
• acetaminophen / ibuprofen
• cough syrups
• and rest.

Possible Prescriptions:

• Nasal Steroids
• ATB’s if indicated: the first line is Amoxicillin

For Penicillin allergic patients alternatives are:

• Cephalosporins
• Doxycycline
• Sulfa-Trim

Reference:

• Griffith’s 5 Minute Consult for PDAs.