Tuesday, January 31, 2023

Are Antibiotics Good For Sinus Infections

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Which Antibiotics Are Most Effective For Bacterial Sinusitis

Wellness Wednesday: Antibiotics for sinus infections?

Antibiotics are indicated for sinusitis that is thought to be bacterial, including sinusitis that is severe or involves the frontal, ethmoid, or sphenoid sinuses, since this type of sinusitis is more prone to complications. Penicillins, cephalosporins, and macrolides seem to be equally efficacious. A 5- to 10-day regimen of amoxicillin 500 mg 3 times a day is recommended as first-line therapy.

One study suggests that a single dose of 2 g of extended-release azithromycin may be more effective than a 10-day course of amoxicillin/clavulanate. However, azithromycin is not likely a good choice in sinusitis because symptoms may improve only because of the anti-inflammatory efficacy of the agent and because it has poor efficacy against S pneumoniae and H influenzae. The risk of adverse effects should be weighed against the severity of disease and patient comorbidities prior to initiating antibiotic treatment.

Patterns of bacterial resistance should also be taken into account in the choice of antibiotic.

References
  • Lucas JW, Schiller JS, Benson V. Summary health statistics for U.S. adults: National Health Interview Survey, 2001. Vital Health Stat 10. 2004 Jan. 1-134. .

  • Slavin RG, Spector SL, Bernstein IL, Kaliner MA, Kennedy DW, Virant FS, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005 Dec. 116:S13-47. . .

  • Lusk RP, Stankiewicz JA. Pediatric rhinosinusitis. Otolaryngol Head Neck Surg. 1997 Sep. 117:S53-7. .

  • Common Antibiotics For Sinus Infections

    Antibiotics may be prescribed when symptoms of a sinus infection warrant such treatment. Common antibiotics for sinus infection include:

    • Zithromax
    • Levaquin : Although this drug is often prescribed as a first line of therapy for sinusitis, it has serious side effects and should only be used as a last resort.

    But Sometimes Antibiotics For Sinus Infections Are Needed

    So how does one judge when it is appropriate to prescribe antibiotics for a sinus infection? There are several sets of official guidelines, which are all similar. When a patient has thick, colorful nasal discharge and/or facial pressure or pain for at least 10 days, they meet criteria for antibiotic treatment. If a patient has had those symptoms, but the symptoms seemed to start improving and then got worse again, then even if its been less than 10 days, they meet criteria for antibiotic treatment.

    The authors, however, also suggest that doctors discuss watchful waiting with patients and explain that most sinus infections clear up on their own in one to two weeks, and its a safe option to hold off on antibiotics. The symptoms can then be treated with a cocktail of over-the-counter medications and supportive care, like nasal saline irrigation, nasal steroid sprays, decongestants, and pain medications.

    Of course, many patients expect and demand antibiotics for sinus infections, and even those who are open to watchful waiting may hear about the rare but possible complications of things like, oh, brain abscess, and opt to treat.

    In the case of my patient above, she met criteria for treatment. She weighed the watchful waiting option against the potential risks of antibiotics for her sinus infection, and chose the prescription. I can tell you from very close follow-up that she improved quickly, though in truth, we will never really know if she would have gotten better anyway.

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    When To Seek Medical Care

    See a doctor if you have:

    • Severe symptoms, such as severe headache or facial pain.
    • Symptoms that get worse after initially improving.
    • Symptoms lasting more than 10 days without improvement.
    • Fever longer than 3-4 days.

    You should also seek medical care if you have had multiple sinus infections in the past year.

    This list is not all-inclusive. Please see a doctor for any symptom that is severe or concerning.

    Other conditions can cause symptoms similar to a sinus infection, including:

    • Seasonal allergies
    • Colds

    Using The Right Water During Saline Rinses

    Top 8 Sinus Infection Natural Remedies

    When using saline nasal rinses, tap water should always be boiled and then allowed to cool to ensure cleanliness distilled water or premixed solutions could also be used instead of regular tap water.

    Other home remedies for sinus infections include:

    • Drinking fluids: Drinking lots of fluids helps loosen and thin mucus. Avoid beverages that are caffeinated and alcoholic beverages that can dehydrate the body, which could thicken mucus.
    • Breathing steam: Warm water is best . You can breathe in steam from either a bowl or shower.
    • Humidifying the air: Use a cool air vaporizer or humidifier,particularly at night while sleeping.
    • Avoiding environmental substances: Avoid tobacco smoke and chlorinated water that can dry up the mucus membranes and exacerbate symptoms.
    • Implementing treatment measures: At the first sign of infection, use antihistamines and employ regular nasal rinses.

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    Research Into Antibiotics And Sinus Infections

    The guidelines were triggered, in part, by studies finding that antibiotics may not make a difference. About 60% to 70% of people with sinus infections recover without antibiotics, according to the American Academy of Allergy, Asthma & Immunology.

    In one study of symptom relief, patients given antibiotics generally did no better than patients not given antibiotics.

    This study, published in the Journal of the American Medical Association, observed 240 patients with sinusitis. They were given one of four treatments: antibiotics alone, nasal steroid spray alone to reduce tissue swelling, both antibiotics and the spray, or no treatment.

    Patients who got no treatment were as likely to get better than those who got the antibiotics. The nasal spray seemed to help people with less severe symptoms at the beginning of their sinus problem, and seemed to make those with more intense congestion worse.

    The patients all had sinus symptoms that suggested a bacterial infection. Sinus problems are also caused by viruses, for which antibiotics definitely offer no help.

    Dosage Of Doxycycline For Sinus Infection

    The medicine of Doxycycline is available in the following forms-

    • Tablets
    • Liquid form
    • Intravenous solution

    Doctors prescribe to take this medicine in the form of pills for people suffering from sinusitis. There are various strengths of Doxycycline for sinus infection- 50, 75, 100, and 150 mg. In order to take the medicine, theres no need to crush or break it. Take one tablet whole while drinking one full glass of water with each dose.

    For adults-

    Unless prescribed otherwise by doctors, usually the normal dose of oral form of doxycycline is 200 mg on the first day of the course. Followed by, changing the dosage to two 100 mg doses 12 hours apart. After this, maintaining a dose of 100 mg regularly for 7-10 days.

    Although in rare cases, when the infection is severe, doctors can recommend higher doses such as 300 mg daily for 10 days.

    For children-

    Children over 8 years of age can take doxycycline for sinus infection. The dosage of the medicine depends on the childs weight.

    Make sure that the course of the medicine is completed. Also, dont stop the medicine abruptly without proper consultation with the doctor.

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    Antibiotics For Sinus Infection

    A sinus infection, also referred to as sinusitis, is more than just having trouble breathing through your nose. Its an infection and inflammation of your sinus cavities.

    While most sinus infections are viral and do not require antibiotics, when the infection lasts more than seven to ten days, it may be caused by bacteria and its likely youll need antibiotics.

    What Respiratory Tract Illnesses Need Antibiotics

    Antibiotics & Sinus Infections

    While sinusitis rarely requires antibiotic treatment, there are some respiratory diseases that warrant use of antibiotics more often.

    Pneumonia is one of them. Especially for young children and older people this lung infection can potentially be life-threatening. Typical symptoms are chest pain, high fever, breathing difficulties and general weakness. In particular, if the patient suffers from shortness of breath and associated blood oxygen depletion, its recommended to seek medical help.

    Strep Throat is another respiratory sickness caused by bacteria that sometimes requires the use of antibiotics. Its symptoms include a severe sore throat that is accompanied by high fever and swollen infected lymph nodes . Swollen tonsils that show white spots is another symptom. Strep throat doesnt include coughing or runny noses. So, if you suffer from the latter two, its most likely not strep throat.

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    When Do I Actually Need Antibiotics For A Sinus Infection

    There are several guidelines for determining if a patient actually needs antibiotics for a sinus infection. If you have thick, colorful nasal discharge and/or facial pain for at least 10 days, you meet the criteria. This does not mean if you have a slightly yellow or clear nasal discharge for 10 days having discharge from the nose for at least 4 weeks is normal in the case of sinus infections.

    The second criterion is if your symptoms have improved but then got worse again, even if its been less than 10 days. This is referred to as double worsening and is a common scenario in bacterial infections. However, even then, you may want to follow what doctors suggest as watchful waiting. Wait 2 weeks and see if symptoms got better. Use over-the-counter medications and supportive care , as they often do the trick.

    What Is A Sinus Infection Or Sinusitis

    Inflammation of the air cavities within the passages of the nose is referred to as sinusitis. Sinusitis can be caused by infection , but also can be caused by allergy and chemical irritation of the sinuses. A sinus infection occurs when a virus, bacterium, or fungus grows within a sinus.

    Sinusitis is one of the more common conditions that can afflict people throughout their lives. Sinusitis commonly occurs when environmental pollens irritate the nasal passages, such as with hay fever. Sinusitis can also result from irritants, such as chemicals or the use and/or abuse of over-the-counter nasal sprays, and illegal substances that may be snorted or inhaled through the nose. About 30 million adults have “sinusitis.” Colds differ from sinusitis and are only caused by viruses and last about seven to 10 days while sinusitis may have many different causes , and usually last longer with more pronounced and variable symptoms.

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    When Antibiotics Are In Order

    The main reason to prescribe antibiotics is for patient comfort, Dr. Sindwani says. The medical field used to be more convinced than it is today than untreated sinusitis would inevitably become a chronic issue, he says.

    We dont think that way as much, he says. We dont know that an untreated acute sinusitis, if left untreated, will grumble along and cause people to have a chronic sinus infection.

    Some people think thats two separate things, with chronic sinusitis more likely due to underlying issues like allergies or immune problems.

    What Are The Best Antibiotics For Sinus Infection Do Doctors Prescribe For You

    Antibiotics for sinus infection

    There are many antibiotics that your doctor or physician may prescribe to help treat your sinus infection. Some of these may even be familiar to you.

  • Ciprofloxacin This drug is used to treat conditions including urinary tract infections, specific types of infectious diarrhea, bone and joint infections, respiratory tract infections, typhoid, and other forms of bacterial infection.
  • Trimethoprim This drug is the brand name for a medication that is a combination of two antibiotics: trimethoprim and sulfamethoxazole that is used to treat bacterial infections. Bactrim works by preventing the growth of bacteria.
  • These antibiotics are effective in treating sinus infection, however, these drugs do carry side effects. You should only be taken according to what your doctor or physician has prescribed. Always follow their instructions to achieve the best results.

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    How To Treat Sinus Infections Without Antibiotics

    While sinus infections caused by viruses, allergies, or other non-bacterial factors may not require antibiotics, they still cause the same symptoms which make you feel sick.

    Symptoms of a sinus infection include:

    • Nasal congestion
    • Pain or tenderness around the eyes, cheeks, or forehead
    • Thick nasal or post-nasal drainage

    Taking steps to alleviate your sinusitis symptoms is often the best treatment to lessen your discomfort.

    Sinus infection treatment options include:

    • Drink plenty of fluids
    • Rest, especially the first few days, to help your body fight the infection
    • Moisturize the air with a cool-mist vaporizer
    • Elevate your head while sleeping to decrease post-nasal drip
    • Take warm showers or baths, as steam can soothe your sore throat and loosen mucus
    • Gargle with warm salt water for a sore throat
    • Use saline nasal spray or nasal irrigation kit to alleviate congestion
    • Use over-the-counter treatments, such as nasal drops and sprays or pseudoephedrine pills, as your doctor recommends them

    What Not to Do for a Sinus Infection

    You should always follow your doctors instructions when you are diagnosed with a sinus infection.

    Do not:

    • Ask for antibiotics if your doctor feels they are unnecessary
    • Take antibiotics that are prescribed for someone else
    • Skip doses of your antibiotics or stop taking your antibiotics early when your doctor prescribes them
    • Save antibiotics for the next time you get sick

    Most Sinus Infections Dont Require Antibiotics

    Ah, . The New England Journal of Medicine published a clinical practice review of acute sinus infections in adults, that is, sinus infections of up to four weeks. The need for an updated review was likely spurred by the disconcerting fact that while the vast majority of acute sinus infections will improve or even clear on their own without antibiotics within one to two weeks, most end up being treated with antibiotics.

    It is this discrepancy that has clinical researchers and public health folks jumping up and down in alarm, because more unnecessary prescriptions for antibiotics mean more side effects and higher bacterial resistance rates. But on the other hand, while 85% of sinus infections improve or clear on their own, theres the 15% that do not. Potential complications are rare, but serious, and include brain infections, even abscesses.

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    Upper Respiratory Infection Symptoms

    • Fatigue
    • Headache

    Fever is a rare symptom of the common cold in adults but may be more likely in children.

    Symptoms of an upper respiratory infection can last up to two weeks but usually peak at around three days and are gone within seven. Upper respiratory infections should clear up on their own without needing interventions from your healthcare provider.

    But complications of colds can occur, including:

    • Sinusitis: An infection in your sinuses causing pain and congestion
    • Otitis media: An ear infection causing pain
    • Pharyngitis: A sore throat, which might be strep throat
    • Epiglottitis: An infection and resulting swelling of the epiglottis, a flap of tissue that covers your windpipe, which can interfere with breathing
    • Laryngotracheitis: Infection of the larynx , trachea, or bronchi

    Some of these complications may require treatment with antibiotics.

    When To Consider Antibiotics For Sinus Infections

    Reasons For Recurrent Sinus Infections – Northwest Community Healthcare

    AAAAI advises that antibiotics for sinus infections should be considered only if you develop a fever of 102° F or higher, you have severe face pain and tenderness, your symptoms last longer than a week or so, or your symptoms improve and then worsen again.

    Some patients with acute sinusitis do need antibiotics, and if they continue with a worsening infection without treatment, they can suffer dramatic complications such as loss of vision, meningitis, or brain abscess, Patel says.

    If your doctor says you need an antibiotic, ask for generic amoxicillin/clavulanate, according to guidelines from UpToDate, which provides evidence-based treatment information to healthcare providers. Its usually the best choice and works as well as more expensive brand-name antibiotics.

    Avoid taking fluoroquinolones, a group of antibiotics that includes ciprofloxacin and levofloxacin . Although widely used, the antibiotics are inappropriate for treating sinus infections and they pose serious risks.

    In 2016, after a safety review, the Food and Drug Administration linked fluoroquinolones to disabling and potentially permanent side effects. The agency advised against using the drugs to treat common illnessesbronchitis, sinus infections, and urinary tract infections.

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    Sinus Infection Definition And Facts

    • Sinusitis or sinus infection is inflammation of the air cavities within the passages of the nose.
    • Sinusitis can be caused by infection, allergies, and chemical or particulate irritation of the sinuses.
    • The fastest way to get rid of a sinus infection can include medications, home remedies, alternative therapies, and surgery.
    • Most people do not spread sinus infections to other people.
    • Sinusitis may be classified as acute sinus infection, subacute sinus infection, chronic sinus infection, infected sinusitis, and noninfectious sinusitis.
    • Sinusitis signs and symptoms include

    If You Think You Have A Sinus Infection

    If you feel you are experiencing sinus infection symptoms, make an appointment with your PartnerMD physician, and do not attempt to treat symptoms on your own. While you may initially be recommended OTC treatments, only your doctor can accurately diagnose your symptoms, and prescribe the right treatment for relief.

    Have a question about your sinus infection symptoms? Contact us today to see if a relationship with a concierge doctor could be beneficial.

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    Antibiotics Are Not A Good First Choice For Sinus Infections

    People often are quick to ask their doctor for an antibiotic prescription when they suffer from a bad flu or sinus infection. These infections can be annoying, with congested noses, headaches, pain all across the face and never-ending mucus. People just want to make the pain and discomfort go away and get on with their lives. Thats understandable, but antibiotics most likely wont better their situation, as has been shown in countless studies. This is because sinusitis, like most infections of the upper respiratory tract, are caused by viruses, not bacteria. And antibiotics only go after bacteria.

    Actually, taking antibiotics can make you feel sicker, since your body is already weakened by the viral infection and now you expose it to the stress of antibiotics side effects. All antibiotics have side effects, so they should only be taken when it makes medical sense, such as when treating a bacterial infection.

    More generally, you want to keep your antibiotics use at a minimum. Because the more you use antibiotics, the more likely you are to get ill in the upper respiratory tract in the future, as the antibiotics not just kill bad bacteria but also the good bacteria in your body that help protect your health.

    It, therefore, is recommended not to immediately treat every sinus infections with antibiotics, but preserve them as heavy ammunition for the most severe cases.

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