Sinusitis: Mostly Viral, Massively Over-Antibiotic'd, and Green Mucus Proves Nothing

Summary

Most acute sinusitis is viral and self-limiting, antibiotics deliver only marginal benefit against a real harm rate, and the "green or yellow mucus means bacterial" rule is a physiological myth — so for the typical case the honest levers are symptomatic (analgesia, nasal saline, time) and watchful waiting, not a script — yet a genuine minority does warrant antibiotics (symptoms past about 10 days without improvement, severe onset, or double-worsening), and the rare orbital or intracranial complications (eye swelling, vision change, severe or neurological headache) are same-day emergencies, not