Many parents are afraid to talk about antibiotics and believe that they are harmful to their children, so they often secretly reduce the dosage or stop taking them early, or even refuse to use them. So, should antibiotics be used for the treatment of sinusitis in children? If so, what is the duration of treatment? The guidelines clearly state that antibiotics and topical steroid hormones can fight both infection and allergic reactions and are currently the drugs of choice for the treatment of chronic sinusitis in children. For acute sinusitis, amoxicillin/clavulanic acid potassium and cephalosporins with second and third generation are better, and these two classes of antibiotics are the most widely used in clinical practice. Acute sinusitis and recurrent acute sinusitis are usually used for 2 weeks, or continued for 1 week after purulent drainage subsides. Chronic sinusitis can be treated with appropriate antibiotics based on the results of bacterial culture and drug sensitivity tests, and anti-anaerobic drugs are applied when necessary. In addition, patients with persistent purulent discharge with negative bacterial cultures, no metaplasia and poor efficacy of topical steroids usually respond better to treatment with macrolide antibiotics (e.g., erythromycin, roxithromycin, clarithromycin and azithromycin). The dosage for children is 1/2 of the conventional antibacterial dose and the course of treatment needs to last more than 12 weeks. Most treatment strategies are to discontinue the drug after 3-6 months of use and to observe changes in the disease. In some patients, symptomatic improvement may persist for a longer period of time after discontinuation of treatment, while in some patients the disease may recur after 1 month of discontinuation. If the disease relapses, treatment can be restarted; if the patient’s first treatment response is good, relapse after re-treatment is equally effective. This shows that the correct use of antibiotics is the key to treating sinusitis, and should not be “overkill” or even “demonized”.