الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The Viral infection is the main cause of infective ARS and the bacterial infection is only responsible for about 0.5 to 2 % of all adult ARS. In spite of this fact, antibiotics are frequently prescribed to the patients with ARS.
Many clinical guidelines proposed diagnostic criteria for differentiation between ABRS and AVRS. These criteria depended on the patient symptoms, the disease signs and\or laboratory investigations.
The aim of this study was to compare the diagnostic accuracy of two of these guidelines; EPOS and IDSA2012 guidelines.
This prospective study included 69 patients aged between 18-65 years who presented with symptoms suggestive of acute rhinosinusitis. All patients were presented to the Outpatient Clinic of the Department of Otorhinolaryngology, Alexandria University in the period from March 2019 to February 2020
All patients were subjected to informed consent taking before the examination, Detailed history taking, Full ENT clinical examination, Temperature measurement provided that the patient had not received any antipyretic medications 6 hours before the measurement, and investigations that included Serum C reactive protein (CRP), erythrocyte sedimentation rate (ERS) and Middle meatal bacterial culture.
Every patient who included in the study was diagnosed as ABRS or not according each guidelines diagnostic criteria for ABRS. These results were compared with the results of a gold standard for objective diagnosis of ABRS. We used the results of middle meatal swab bacterial culture as a gold standard for ABRS diagnosis.
The diagnostic accuracy for both guidelines was assessed in the terms of specificity, sensitivity, accuracy, likelihood ratios, the positive Predictive Value and the negative Predictive Value.
Also the degree of the agreement between the two guidelines was assessed by the calculation of Kappa coefficient and showed a moderate agreement between both guidelines.
from the study we conclude that both guidelines had a moderate accuracy for diagnosing ABRS. EPOS had a better specificity than IDSA2012 with percentages 70.97% & 41.94% respectively. And IDSA2012 had a better sensitivity than EPOS with percentages 65.79% & 47.37%respectively.
So when the aim is to rationalize the unnecessary antibiotic prescriptions in ARS patients, EPOS guidelines might be more appropriate.