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Distinguishing children with acute bacterial sinusitis who might benefit from antibiotics from those with viral upper respiratory infections is a common and perplexing dilemma. These researchers explored whether nasopharyngeal culture results or the nature of the nasal discharge would help. They enrolled 510 children (age range, 2–5 years) with nasal discharge, cough, or both. Symptom-related criteria for inclusion were illness duration of 11 to 30 days without improvement; worsening symptoms after a period of improvement; or new-onset fever, at 6 to 10 days into the illness. Children with severe and acute onset of symptoms (including initial fever for ≥3 days) were excluded, as were those with severe chronic respiratory conditions. Childre…