Phenoxymethylpenicillin is the recommended first-line antibiotic for the small subset of sinusitis that is genuinely bacterial, typically signalled by symptoms beyond ten days with fever, purulent discharge and marked one-sided pain, or by deterioration after initial improvement.

The condition it treats

Acute sinusitis follows colds and is overwhelmingly viral in its first week and a half. The consultation separates the inflammatory majority (steroid spray, see the mometasone pathway) from the bacterial minority that meets antibiotic criteria.

How the service runs on Scripter

Patients book online, complete the pre-consultation questionnaire, and the guided pathway walks the practitioner through the acute bacterial sinusitis consultation with the screening and counselling steps built in. The supply decision, the record and any GP notification are produced in the same flow, documented against the exact protocol version in force.

Training and eligibility requirements.

Who can deliver this service, and who it can be delivered to. The governing PGD document defines the definitive inclusion, exclusion and supply criteria; the Scripter consultation pathway enforces them, and every consultation is documented against the protocol version it ran under.

Practitioner training

✓Registered healthcare professional from a profession authorised to supply under PGDs (Schedule 16, Part 4 of the Human Medicines Regulations 2012), such as a pharmacist, nurse, paramedic or physiotherapist, with current registration with their professional regulator

✓Practising from premises suitable for the service, such as registered pharmacy premises or a registered clinic

✓Assessed clinical competency for this service, declared and reviewed as part of PGD authorisation

✓Sign-off against the current version of this PGD in Scripter before first supply; sign-offs expire automatically when the protocol is updated, and the platform notifies everyone affected

✓In-date basic life support and safeguarding training

✓Indemnity arrangements covering the service

Patient eligibility

✓Patients meeting national criteria for bacterial sinusitis (duration, severity or double-sickening)

✓Penicillin allergy excluded (clarithromycin pathway available)

✓Periorbital swelling, severe systemic illness or neurological signs referred urgently

✓Safety-netting and GP notification completed

Phenoxymethylpenicillin PGD questions

What is double-sickening?+

Improvement followed by clear deterioration, one of the strongest signs a viral sinusitis has picked up a bacterial passenger, and one of the criteria the pathway checks.

Why might a patient leave with a nasal spray instead?+

Because most prolonged sinusitis is inflammatory; when antibiotic criteria are not met the pathway offers the evidence-based alternative rather than a consolation antibiotic.

How long is the course?+

The course length follows the governing PGD and current national guidance, and the label, record and GP notification all state it consistently.

More upper respiratory infections PGDs.

Related protocols in the same category, all delivered through the same platform.

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Phenoxymethylpenicillin PGD.

What is Phenoxymethylpenicillin?