Schupper AJ, et al. - Researchers identified the risk factors related to the complicated clinical courses. They also assessed for altering microbial communities and increased antibiotic resistance. The predictors of a more severe infection requiring more surgical interventions, prolonged intravenous antibiotic treatment and overall hospital length of stay were frontal sinus involvement and anaerobic and polymicrobial sinus cultures. In this study, the prevalence of streptococcus pneumoniae was not was not seen. The microbial profile of this patient subset demonstrated a shift from the previous studies, which could likely be attributed to the adoption of pneumococcal vaccinations. A greater predictivity of a complicated clinical course was noted with sinus cultures vs intracranial cultures, thereby suggesting the importance of a thorough sinus debridement and obtaining directed sinus cultures.