When Does Antibiotic Resistance Occur
Antibiotic resistance occurs in a persons own body and within the community when certain drugs no longer work for a specific type of germ. This can occur when bacteria change in response to exposure to antibiotics so that the antibiotics no longer work efficiently against the bacteria.
Therefore, allergists and other specialists recommend limiting the use of antibiotics unless:
- Symptoms last over seven to 10 days
- Specific symptoms are present
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Symptoms > 1 Week Are Not A Reason To Prescribe
One very important new finding in this meta-analysis that should change practice is that the duration of illness did not predict a positive response to antibiotics.
Current national recommendations are to use an antibiotic for patients with a duration of illness longer than 1 week, as these patients are presumably more likely to have a bacterial infection.5–7 However, that recommendation had been based on expert opinion, not on data from clinical trials. A longer duration of symptoms should not be a reason to prescribe an antibiotic for sinusitis symptoms.
How Can You Help Your Patient
What to do, then, for patients with acute sinusitis? Treat the symptoms, which means recommending pain medication for facial pain or headache and saline nasal spray for the nasal discharge, not antibiotics or nasal corticosteroids. Side effects will be fewer and costs will be lower.
- Saline irrigation. A 2007 Cochrane review of 8 chronic and recurrent sinusitis trials showed that nasal saline irrigation is effective for reducing symptoms of chronic and recurrent sinusitis.8 Although we do not have high-quality RCT data on saline nasal irrigation for treatment of acute sinusitis, nasal saline irrigation is harmless and inexpensive.
- What about nasal steroids? The evidence is equivocal, and the most recent high-quality RCT of nasal steroids showed no effect.9
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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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Sinusitis: What To Do If Antibiotics Dont Work
Many people turn to antibiotics hoping for relief from their sinusitis symptoms. Unfortunately, this is a misguided pursuit by many of them: Research published in TheJournal of Family Practice concludes that antibiotics are ineffective at treating sinusitis — even in extreme cases where symptoms are severe. Which begs the question: If antibiotics donât work for your sinus problems, what can you do to ease your pain? Hereâs a closer look.
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How Is Sinusitis Treated
Your treatment will depend on the cause of your sinusitis. Most of the time, treatment includes medicines and taking care of yourself at home. Medicines that are used most often include:
- , such as Sudafed, that are taken as pills or liquids. These can reduce swelling and improve sinus drainage.
- Over-the-counter pain medicine, such acetaminophen or ibuprofen .
- Antibiotics, which kill bacteria. Antibiotics will only work if your sinusitis is caused by bacteria. Most of the time, sinusitis is caused by a virus.
How Is Sinusitis Diagnosed
If you are experiencing pain and pressure that doesnât clear up within a week to 10 days, it may be time to schedule a doctors appointment. You can visit your primary care physician to be evaluated for a sinus infection.
A sinus infection is usually diagnosed empirically without need for imaging or cultures, explains Lindsey Elmore, Pharm.D., BCPS. A simple medical exam and review of your symptoms should be enough for your doctor to identify a sinus infection. Your doctor will likely check your nose with a light to look for inflammation. He or she also may ask you about any pain youre feeling to see if it traces back to the sinus cavities.
In rare cases, or if you get frequent infections, your doctor may perform other tests to rule out other conditions like a fungal infection. This may include allergy testing, a nasal endoscopy to visually inspect the sinuses, swabbing your nose for a culture of nasal drainage, or lab imagery to scan for abnormalities.
Symptoms may be acute or chronic , and you should seek a doctors help if you have symptoms that last more than 10 days, or are unresolved with over the counter agents as this may be an indication that you have a bacterial sinus infection, says Dr. Elmore.
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Caveats: Refer Seriously Ill Patients And Complicated Cases
A very important caveat to our recommendation is that seriously ill patients must be managed differently. Very infrequently a patient develops a serious complication of acute sinusitis such as brain abscess, periorbital cellulitis, or meningitis. Therefore, seriously ill patients with signs and symptoms of acute bacterial sinusitis, such as high fever, periorbital erythema or edema, severe headache, or intense facial pain must be carefully evaluated and treated with great caution and close follow-up. These patients should be referred immediately for consultation with an otolaryngologist.
When Do I Need Antibiotics For Sinus Infection
- Oyewale Oyelami
Do I need antibiotics for sinus infection? Using antibiotics to treat a sinus infection depends on what caused the infection- a virus or a bacterium. Doctors wont prescribe an antibiotic if your sinus infection starts because of a virus. So lets dive into this a bit more.
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When Antibiotics Dont Work
Some patients suffer from recurring sinus infections. If your sinus infection does not improve within five to seven days after you finish the whole course of antibiotics, or if you experience another sinus infection within a few weeks, you may be referred to an Ear, Nose and Throat specialist for treatment.
How Well Do Antibiotics Work For Sinusitis
Antibiotics can only be effective against bacterial sinusitis. Antibiotics wont help if an individual has viral, fungal, or another type of sinusitis.
When do I need antibiotics for sinus infection? If you have bacterial sinusitis, treatment with the right antibiotics will help eliminate the infection. However, it is essential to remember that some studies show that antibiotic therapy doesnt always lessen symptom duration or the chance of developing complications.
According to recent statistics, antibiotic treatment cures five to 11% of people faster than if they didnt get treatment. Additionally, several cases of bacterial sinusitis go away by themselves in about two weeks.
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How Long Do Antibiotics Take To Work On Sinus Infections
Often, sinus infections are treated with antibiotics. However, your doctor will determine the best treatment based on the root cause of your sinus infection. If antibiotics are prescribed, you may want to know how long it will be before you start to experience relief from symptoms.
Read on to find out how sinus infections are diagnosed, when your doctor may prescribe antibiotics, and how long it will take antibiotics to take effect.
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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 improving.
- Symptoms lasting more than 10 days without getting better.
- 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
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What Is Chronic Sinus Infection
Chronic sinusitis is a long-standing inflammation of your sinuses that lasts for 12 weeks or longer at a time. Sinusitis is also known as rhinosinusitis . So, we use the two terms interchangeably. When inflamed, nasal passages and sinuses become swollen and blocked. Chronic sinusitis interferes with the normal drainage of the mucus. Too much mucus builds up in your nose and sinuses, making them stuffy.
Sinusitis Resistance To Antibiotic
Bacteria resistance to antibiotics is a big problem throughout the United States. Several common bacteria behind sinusitis can carry a gene that makes them resistant to the effects of antibiotics. Youll notice this after a few days of treatment when the gene activates. It can even travel between bacteria in a plasmid capsule, affecting a large population of bacteria.
When you dont show improvement after a course of antibiotics within four to seven days, especially if you did seem better at first but then got worse again, you might be dealing with resistant bacteria. Talk to your physician about an examination and potential culture or sinus DNA analysis. These tests can identify the most harmful resistant strains within about 24 hours and offer a comprehensive bacterial analysis within one week.
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How Doctors Are Curbing Antibiotic Overuse
As the people prescribing antibiotics, providers need to be at the center of this effort. Every time we go to write a prescription for an antibiotic, we should ask ourselves if its truly needed. We also cant give in to pressure from patients who demand an antibiotic when we know it wont help them.
Antibiotic stewardship programs have proven to be extremely useful to help us target a particular bacteria with the right antibiotic based on our population. Our infectious disease specialists monitor bacteria and antibiotic resistance patterns in the Dallas-Fort Worth area. Every community uses antibiotics differently. Because of this, bacteria and antibiotic resistant infections here may differ from those in Los Angeles.
For example, if I treat a patient with a UTI that I know was caused by an E. coli bacteria, I can look up the specific bacteria and see whats called an antibiogram. This tells me which antibiotics are used to treat the bacteria and what percent chance they have of working in the Dallas-Fort Worth population. So if a large number of residents here are resistant to ciprofloxacin, I will choose something else.
This works on two levels: It creates buy-in from the physician and educates the patient even before the doctor enters the room. This study was new to me, but I think this technique is brilliant and plan to use it in our Richardson/Plano clinic!
Your Sinusitis Wont Go Away Heres What You Need To Know
Sinusitis also known as a sinus infection is, for the most part, a bacterial infection caused by inflammation of the sinuses. Chronic and recurring long-lasting sinusitis can render you incapacitated and quickly eat up your sick days.
But when your sinusitis wont go away, what options do you have? This guide walks you through how to identify a sinus infection, what happens if you ignore it, how to treat your chronic sinusitis, and more.
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Potential Problems With Antibiotic Use
I had a discussion with a patient recently about using antibiotics.
Her question was why not just use them? Even if you dont actually need them, whats the harm in trying to see if we get lucky?
Unfortunately, as amazing as antibiotics are, they arent without risks and side effects. This holds true for ANYTHING that we put inside our bodies.
Fun fact: Did you know that even too much vitamin C can be toxic to our bodies?
Here are some of the important downsides to taking antibiotics that most people arent aware of. Consider these before begging to be put on antibiotics.
Why Didnt My Doctor Give Me An Antibiotic
Patients often expect antibiotics for their illnesses, not understanding that in many cases antibiotics will not make them better faster, and could cause more harm than good.
Over the past 50 years, antibiotics have been over prescribed for three reasons:1) colored sputum or snot must indicate infection2) antibiotics can prevent colds, allergies or flu from developing into a bacterial infection3) antibiotics canât do any harm.
However, medical science has clearly demonstrated all three of these presumptions are incorrect.
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Should You Visit A Specialist
If your sinus infection just wont go away or keeps coming back, it may be time to see an ear, nose, and throat specialist. An ENT treats conditions of the ear, nose, throat, head, face, and neck. It may be time to see an ENT if:
- Youve completed several courses of antibiotics without success
- Your doctor suspects nasal polyps or another blockage of the nasal cavity
- You have chronic sinusitis that lasts longer than 12 weeks
Living with a sinus infection is miserable and living with a sinus infection for weeks on end is worse. Contact your doctor or an ENT to get the treatment you need.
Surgical Treatment For Chronic Sinusitis
Although medical therapy and lifestyle tweaks are the first-line treatment for chronic rhinosinusitis, some people may fail to respond to optimal therapy. In such cases, Ear, Nose Throat and Allergy Specialist performs a surgery to widen up the blocked sinuses and remove any trapped mucus or polyps.
Other situations in which surgery could be considered include:
- When chronic sinusitis symptoms do not respond to the medical treatments listed above, and CT scan of your sinuses reveals complete blockage of one or more sinuses.
- When nasal polyps fail to shrink enough with steroids.
- When a severe deviation of the septum completely blocks your nose or hinders sinus drainage.
- When theres a suspicion of allergic fungal sinusitis. The sinuses in allergic fungal sinusitis get clogged with thick, dense mucus that is hard to remove in any way other than surgery.
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What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take antibiotics for sinusitis
Reasons not to take antibiotics
I know I have a bacterial infection that is causing my sinusitis.
A virus is causing my sinusitis.
What Prescription Medications Treat A Sinus Headache Pain And Pressure
Headaches from allergies can be relieved with a prescription for nasal steroids sprays unless there is a contraindication. This may be helpful along with nasal saline rinses to decrease inflammation within the nasal passages and treat or prevent sinusitis.
If a bacterial infection is suspected, the health-care professional may prescribe antibiotics to treat the infection and at the same time make suggestions to treat the underlying inflammation. To establish the diagnosis of acute bacterial rhinosinusitis and the need for antibiotics, your doctor should confirm that symptoms of acute rhinosinusitis have been present for 10 days or are worsening. Symptoms should include pus-like nasal drainage, nasal obstruction, facial pain, or pressure. If the inflammation does not resolve before the antibiotic course is complete, the bacterial infection may recur.
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What To Do When Your Doctor Wont Give Antibiotics
I love winter in Florida: the nice weather and lack of snow, but not the colds that come with it. As a pharmacy student, I walk a fine line between studying late into the night and waking up with a cold. Nothing like having three exams, two papers and a flaming sore throat to get you through the holidays.
To get through my sickness, I stock up on chicken noodle soup. I make my daily call to my mom. She notices my stuffy nose and asks, Why dont you go to the doctor to get some antibiotics? The pharmacist in me breathes a small sigh of frustration. To understand why, lets look at the history of antibiotics. After all, U.S. Antibiotic Awareness Week is right around the corner .
Antibiotics are a crucial component of modern medicine. They can cure bacterial infections like bubonic plague that once caused the downfall of entire civilizations. However, a problem has arisen: Many bacteria are now immune to antibiotics! This phenomenon is called antibiotic resistance. One contributor to antibiotic resistance is overuse of antibiotics.
According to the Centers for Disease Control and Prevention, 266 million courses of antibiotics are dispensed in U.S. community pharmacies yearly, of which at least 30 percent are unnecessary. The majority of antibiotic prescriptions from doctors offices are for sinus infections, sore throats and chest colds. These types of infections, however, are usually caused by viruses, not bacteria.
Which Children Are At Risk For Sinusitis
A sinus infection sometimes happens after an upper respiratory infection or common cold. The cold causes swelling that can block the opening of the sinuses. This can cause a sinus infection. Allergies can also lead to sinusitis because of swelling and increased mucus. Other possible conditions that can lead to sinusitis include:
-
Abnormal shape of the nose
-
Infection from a tooth
-
Foreign object in the nose
-
Birth defect with abnormality of the roof of the mouth
-
Problem with stomach acids
-
Cystic fibrosis and immunodeficiency syndromes
Immune problems or antibody deficiencies are risks for chronic sinus conditions.
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Why Do I Need Antibiotics For Sinus Infection
You should use antibiotics for a sinus infection when it is clear that its been caused by bacteria.
Its probably a bacterial infection if you notice the following:
- Symptoms persist for seven days or more, especially if they seem to get better and then worsen.
- Your mucus is yellow or green and thick.
- Your facial or sinus tenderness is severe, mainly if one side of your face is worse.
- Pain in your upper teeth area is worse on one side.
Contact your physician if the infection becomes severe, comes back, or isnt getting better on its own.