Final answer:
For acute sinusitis exceeding 10 days duration in a patient with a penicillin allergy, alternative treatments such as azithromycin or cephalosporins can be used, with consideration for fluoroquinolones in severe cases. Each treatment plan should be tailored to the individual's history and clinical presentation.
Step-by-step explanation:
For patients with acute sinusitis lasting more than 10 days who are allergic to penicillin, alternative antibiotics are required. A common approach for such cases, especially if bacterial sinusitis is suspected, is to prescribe a macrolide antibiotic such as azithromycin or a second- or third-generation cephalosporin, provided the patient does not have an immediate-type hypersensitivity reaction to beta-lactams.
If the infection is severe or complicated, and initial alternative antibiotics are not effective, a fluoroquinolone might be considered in adults, although it's important to weigh this decision against potential side effects and the risk of promoting antibiotic resistance. In each case, the treatment should be individualized based on the patient's health history, symptoms, and the likelihood of resistance.