The decision-making process in general practice of when to use antibiotics to treat acute rhinosinusitis

This study illustrates the complexity of diagnosing and managing ARS, shaped by clinical uncertainty, competing priorities and non-clinical pressures. Variation in doctor involvement, diagnostic practices and CRP thresholds reveals the challenges of standardization. Training, guidelines and patient education are valued but may not ensure optimal antibiotic use. Diagnostic decisions are relational, negotiated and context-specific, influenced by public health concerns, patient needs and workflow demands. Without acknowledging this complexity, antibiotic stewardship efforts could potentially fall short.