<unk>  sinus<unk>  is a medical emergency. Pharmacologic medical therapies for<unk>  sinus<unk>  include antithombotic agents, antibiotics, and drugs such as mannitol, steroids and acetazolamide to decrease the intracranial pressure.  Empiric antimicrobial therapy for septic<unk>  of<unk>  or dural venous sinus includes metronidazole plus either nafcillin or oxacillin with either ceftriaxone or cefotaxime. Generally, the preferred empiric regimen for the treatment of<unk>  sinus<unk>  is (Vancomycin 30–45 mg/kg IV q8–12h for 3-4 weeks OR Nafcillin 2 g IV q4h for 3-4 weeks OR Oxacillin 2 g IV q4h for 3-4 weeks) AND (Ceftriaxone 2 g IV q12h for 3-4 weeks OR Cefotaxime 8–12 g/day IV q4–6h for 3-4 weeks) AND Metronidazole 7.5 mg/kg IV q6h for 3-4 weeks. If the risk of MRSA is high,  vancomycin should be used instead of either nafcillin or oxacillin. Other pharmacologic therapies include antithrombotic agents (usually LMWH) to prevent clot formation, steroid therapy (e.g. Dexamethasone 10 mg q6h) for symptomatic relief, and mannitol and acetazolamide to reduce the elevated intracranial pressure. Antiepileptic therapy should be administered only if patients develop seizures.
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