The prevalence of the acute sinusitis in ENT practice is very high. The current prevalence in Russian Federation is roughly estimated at 6 to 15%, and accounts for about 10 million cases a year. The incidence of acute sinusitis increases in autumn and early spring and decreases in the summer. Most cases of acute sinusitis are of a viral etiology, but it can also arise from bacterial infection, allergies, or injuries. The disease is characterized by swelling of the nasal mucous membrane, nasal blockage and discharge. Typically, the duration of acute inflammation of the paranasal sinuses averages about 4 weeks. In case of the inappropriate treatment, the inflammatory process can spread to adjacent anatomical structures – to the orbit, ear, or brain, resulting in serious, sometimes life-threatening complications. Over the last 10 years, the resistance of pathogenic flora to antimicrobial agents has greatly increased due to the unjustifiability and irrationality of their use. The purpose of this review was to analyze the effectiveness and safety of the antibiotic therapy for acute rhinosinusitis. The paper discusses the etiology, pathogenesis, and characteristics of the acute sinusitis. It presents the features of the most used drugs, with special attention to the comparative assessment of their therapeutic effectiveness compared to other antibiotics, as well as determining the optimal schemes for their use within the framework of modern clinical protocols. A description of a clinical case of acute sinusitis and a treatment regimen with Cefixime EXPRESS is presented.