You have returned to the clinic refreshed after your well-deserved vacation. As you look to see your first patient, you realize that your bacterial sinusitis patient is back!
She tells you that her symptoms did not resolve with the new antibiotic. While you were gone, she saw one of your colleagues and a sinus aspirate gram stain, culture, and sensitivity were appropriately done. Your colleague then started your patient on the appropriate antibiotic. The physician also tried a course of inhaled steroids, a nasal lavage, and ordered an allergy assessment. The treatments did not reduce symptoms and the allergy test was unremarkable. It has now been one week since the antibiotic change and there is still no change in symptoms.
A history and physical are unchanged from previous visits.
What should you do?