For this rotation, my site evaluation was completed via BlackBoard Collaborate with my site evaluator and one other student who rotated at a different site.

During the evaluation, each of us presented one patient case/H&P and a related journal article. For this presentation, I presented a case of acute maxillary sinusitis I had seen at the family medicine outpatient office where I was rotating. For this case, my site evaluator had asked which sinuses were most commonly affected by sinusitis. I had answered that the maxillary sinuses were most commonly affected as was seen with the patient in my case and learned that the anterior ethmoid sinuses are also among the most commonly affected after looking it up. Additionally, my site evaluator had asked what the alternative to Augmentin (Amoxicillin-Clavulanate), which was the antibiotic I had prescribed, would be for a patient who is penicillin-allergic. As with other bacterial infections, such as acute otitis media, Azithromycin is an appropriate alternative in the treatment of acute maxillary sinusitis for patients who have a penicillin allergy.

For my journal article, I chose a randomized controlled trial that compared high-dose versus standard-dose amoxicillin/clavulanate for clinically-diagnosed acute bacterial sinusitis. It ultimately found that while the high dose regimen led to more rapid improvement in symptoms, it also came with an increased risk of adverse effects, such as severe diarrhea and vaginal discharge and itching. Moreover, it found that despite more rapid improvement with the high dose treatment, most patients reported major improvement at Day 10 regardless of which treatment regimen they received.