The rationale of our trial1 was to include adult patients with suspected ABRS based on clinical information because in general practice the decision to use antibiotics is usually based on this information. In reply to Dr Weinberg's questions: our inclusion criteria—a history of repeated purulent nasal discharge and maxillary or frontal unilateral or bilateral pain—are symptoms most likely associated with ABRS.2 Patients could present other common symptoms of URTIs, but these were not part of our inclusion criteria. Body temperature was measured in all patients at baseline, but body temperature is a poor predictor of ABRS. No further testing was done to identify patients with allergic rhinitis. In Switzerland, however, this condition is rare in winter and in early spring.
Heiner C. Bucher, James Young, Peter Tschudi. Diagnosing Acute Bacterial Rhinosinusitis—Reply. Arch Intern Med. 2004;164(5):568–570. doi:10.1001/archinte.164.5.570-a