What Is Sinus Infection
Medically known as rhinosinusitis, Sinus infection or Sinusitis is an inflammation or swelling of the tissue lining the sinuses. Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection. It occurs when your nasal cavities become infected, swollen, and inflamed. Sinusitis is usually caused by a virus and often persists even after other upper respiratory symptoms are gone. In some cases, bacteria, or rarely fungus, may cause a sinus infection.
Dont Rush To Antibiotics
The sinuses are small, hollow spaces inside the head. They drain into the nose. The sinuses often cause problems after a cold. They can also cause problems if they get blocked up from hay fever and other allergies. The medical name for sinus problems is sinusitis.
Sinus problems can be very uncomfortable. You may feel stuffed up. You may have yellow, green, or gray mucus. And you may feel pain or pressure around your eyes, cheeks, forehead, or teeth.
Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually do not need antibiotics. Heres why:
Case & Commentary: Part 2
Shortly after starting her second course of antibiotics, the patient began feeling unwell. A few days later, she was found down in her home by her daughter. The patient was brought to the emergency department for evaluation. Her work up revealed profound anemia due to brisk autoimmune hemolysis. This was thought to be due to the amoxicillin-clavulanate she had received. She was started on high-dose immunosuppressive therapy with steroids.
The chief population-level effect of antibiotic overuse is the widespread and growing problem of antimicrobial resistance . AMR is a worsening problem among many bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, and Escherichia coliorganisms that cause common clinical syndromes such as cellulitis, community-acquired pneumonia, and urinary tract infection. Once confined to hospitals, these drug-resistant pathogens are becoming increasingly prevalent in the community setting, and some data indicate that prior treatment with antibiotics may increase an individual patients likelihood of contracting an infection with a drug-resistant bacteria. AMR exerts significant societal costs, as infections with drug-resistant bacteria are associated with increased morbidity, mortality, and health care expenditures.
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What Home Remedies Help Soothe Sinus Infection Or Sinusitis Symptoms
Sinus infections caused by viruses can use home treatments such as pain and fever medications , decongestants, and mucolytics. In addition, some health care professionals suggest nasal irrigation or a sinus rinse solution to help relieve symptoms of sinus infections, even chronic sinusitis symptoms. This irrigation is accomplished with a Neti-Pot or a sinus rinse kit . The last reference of this article shows a video of a sinus rinse procedure. In 2012, the FDA issued a warning about the use of Neti-Pots. The FDA cautions people not to use untreated tap water for rinsing, as contaminated tap water rinses lead to two deaths.
Bacterial and fungal sinus infections usually require antibiotic or antifungal therapy so home treatments without them are often not successful. However, some authors suggest home treatments may reduce symptoms after medical therapy has begun some healthcare professionals recommend nasal irrigation after sinus surgery.
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Doxycycline Dosage For Sinus Infections
The dosage of doxycycline depends upon how bad the sinus infection is. Doxycycline is not the first line treatment for sinus infections but is a suitable alternative in the presence of allergies to penicillin. It is also useful in the management of sinus infections that occur secondary to organisms that are resistant the effect of penicillin. Nonetheless, doxycycline is widely utilised at a dose of 100 mg twice a day for a period of 7 to 10 days in the treatment of sinus infections.
Given the doxycycline is not the first line choice of treatment for sinusitis, its prescription is often delayed and is reserved for patients who have not responded to regular antibiotics given for sinusitis.
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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 âsinusitis.â 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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Ways To Recognize Serious Signs Of Sinus Infections
The length of the infection is an important determinant of the seriousness of the infection.
I usually consider most infections less than 3 weeks to be viral or inflammation related to congestion. At this point, the best treatment is usually medications that decrease the congestion and inflammation. This in turn will alleviate the symptoms and ultimately cure the illness.
When the illness continues beyond 3 weeks, bacterial infection can begin to develop. Though antibiotics can be considered at this point, other treatments may still be the best answer if they have not yet been given a try.
#2: Mucous Color
I will dispel a myth right here and now. Yellowish/greenish mucous does not necessarily mean the infection is bacterial.
Viruses can cause the same color mucous. The reason for the mucous is generally not the actual bacteria or virus, but the bodys immune response to the intruder.
So dont worry just because you see a colored mucous when you blow your nose. This will also improve as the infection abates.
#3: Sinus Pain
Sinus pain can occur anytime throughout a sinus infection. This is normal and means there is inflammation in the sinuses, as we discussed previously.
However, severe pain, redness over the skin, hardened skin over the sinuses, or even a severe headache are not generally normal and can indicate a bacterial infection.
A fever can be caused by both viruses and bacteria. So how do you differentiate between the two?
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When Should You Use Antibiotics
You usually need an antibiotic when you have an infection that is caused by bacteria, and the infection is not going away on its own. This may be the case when:
- Your symptoms last more than 10 days.
- Your symptoms start to get better, but then get worse again.
- Your symptoms are very severe. You should get immediate treatment if:
- You have severe pain and tenderness in the area around your nose and eyes.
- You have signs of a skin infectionsuch as a hot, red rash that spreads quickly.
- You have a fever over 102°F.
What If You Dont Start To Feel Better
Most studies, such as the guidelines to treat ear infections in children, recommend that if no clinical improvement is seen within 48-72 hours of starting amoxicillin, therapy should be reevaluated.
Similarly, the American Academy of Pediatrics guidelines for the treatment of sinusitis states the following:
âAmoxicillin with or without clavulanate is the firstline treatment of acute bacterial sinusitis. Clinicians should reassess initial management if there is either a caregiver report of worsening or failure to improve within 72 hours of initial management.â
So overall, amoxicillin is absorbed quickly after taking a dose by mouth, and you should feel improvement in your symptoms within72 hours. If you do not, it is important to speak with your doctor as your infection may be resistant to the antibiotic, and alternative therapy options should be considered.
Alternative therapies include:
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When Are Antibiotics Prescribed For A Sinus Infection
Your doctor will consider antibiotic treatment if you do not see relief from these initial treatments. If you develop a fever, or tenderness and pain in your teeth, you may be experiencing symptoms of a bacterial sinus infection.
Not all antibiotics are effective for treatment of bacterial sinus infections, so your doctor will look at your medical history and current symptoms to determine the best antibiotic treatment.
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Should You Treat A Sinus Infection With Antibiotics
Over the past few months Ive seen patient after patient drag themselves to the clinic with coughing, sneezing, headaches and green or yellow nasal discharge, sometimes accompanied by ear and tooth pain. Some people with infection may experience fevers, chills or night sweats signs that the body is fighting a virus or bacteria. These are symptoms I expect as a primary care doctor especially during the spring seasons. They are the telltale signs of sinusitis. But if that sums up symptoms you have, do you need antibiotics? The question may be more complicated than you think.
Each year, more than 30 million Americans endure sinusitis an inflammation of sinus spaces surrounding the nose that makes it difficult to drain fluid that normally flows through the sinuses. Much like a detective weighing clues, us health providers use symptom severity and duration to determine the cause of a patients sickness.
The World Health Organization has called antibiotic resistance one of the biggest threats to global health, saying misuse of antibiotics in humans and animals is accelerating the process.
At a health professionals discretion, antibiotics can be prescribed if a person appears very sick or has any underlying chronic disease that may make them prone to becoming sicker.
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Case & Commentary: Part 1
A healthy 53-year-old woman presented to her primary care physician with upper respiratory symptoms and possible sinusitis. She was prescribed Augmentin . Despite this therapy, her symptoms persisted. She was then prescribed azithromycin.
Upper respiratory tract infection symptoms are among the most common presenting complaints to primary care physicians, with 83.1 million visits occurring in 2002 , of which 3.1 million were ultimately ascribed to acute sinusitis in adults. Sinusitis occurs after or in conjunction with a viral URI. Inflammation of the respiratory epithelium lining the paranasal sinuses leads to obstruction of the sinus ostia and accumulation of mucus within the sinuses. The adjacent nasal mucosa is invariably inflamed as well. This process leads to the typical sinus symptoms of headache, nasal congestion and discharge, and facial pain or pressure, sometimes accompanied by sneezing, toothache, or fever.
Maxillary pain or tenderness in the face or teeth.
Mucopurulent nasal discharge.
Symptoms have lasted for 7 days or more.
Despite these guidelines, overtreatment of acute sinusitis with antibiotics is common. A 2007 study found that antibiotics were prescribed in 82.7% of outpatient visits due to acute sinusitis. Many of these prescriptions are unnecessary, as the vast majority of cases of sinusitis are viral in originespecially when symptoms have lasted for less than 1 week.
What Are The Six Types Of Sinusitis And Sinus Infections
Sinusitis may be classified in several ways, based on its duration and the type of inflammation . The term rhinosinusitis is used to imply that both the nose and sinuses are involved and is becoming the preferred term over sinusitis.
- Acute sinus infection usually lasts less than 3-5 days.
- Subacute sinus infection lasts one to three months.
- Chronic sinus infection is greater than three months. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.
- Recurrent sinusitis has several sinusitis attacks every year.
There is no medical consensus on the above time periods.
- Infected sinusitis usually is caused by an uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of a sinus infection usually are the result of incomplete treatment of an acute sinus infection.
- Noninfectious sinusitis is caused by irritants and allergic conditions and follows the same general timeline for acute, subacute, and chronic as infectious sinusitis.
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Sinus Infection Antibiotics No Help
Antibiotics, Steroid Spray No Help for Adult Sinus Infections
One of the most common complications of the common cold or flu is a sinus infection. The symptoms: a stuffy nose a thick, dark-colored nasal discharge and head pain.
Youâve very likely had such an infection. And if, like 25 million other Americans, you went to a U.S. doctor, thereâs a 90% chance you got a prescription for antibiotics.
You very likely had some side effects from that antibiotic. But itâs extremely unlikely the antibiotics you took were much help, according to a study by Ian G. Williamson, MD, senior lecturer at the University of Southampton, England.
âWe are confident that if there is an effect of antibiotics on acute sinus infections, it is not very big â certainly not as big as people have been led to believe,â Williamson tells WebMD.
Williamson and colleagues studied 240 patients ages 16 and older whose symptoms suggested that they had a sinus infection caused by bacteria. Viruses also cause sinus infections, but antibiotics do not help viral infections.
Study patients received antibiotic treatment with amoxicillin, an antibiotic often used for bacterial sinus infections, with or without nasal steroid sprays. A fourth of the patients received no treatment at all, but just got inactive placebo pills and placebo sprays.
Precautions Of Amoxicillin For Sinusitis
It is a general precautionary measure that no medicine should be taken without proper consultation with the doctor.
A person can buy Amoxicillin 500 mg Tablet with only a valid prescription at the pharmacist or medical center.
Some of the things you should disclose to the doctor before taking this medicine are-
- Whether you are allergic to drugs such as clarithromycin, erythromycin, and telithromycin
- Whether you have any issues in the kidneys, muscles, liver or heart
- If you have a low level of potassium or magnesium
- Whether you suffer from nausea, diarrhea or excessive sweating after taking the medicine
- Whether you are pregnant or lactating
Some precautions for special conditions before taking Amoxicillin 500 mg Tablet-
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Antibiotics May Not Help Sinus Infections
10 December 2007
The widespread use of standard antibiotics to treat sinus infections does not help cure patients and may harm them by increasing their resistance to the drugs, according to a study from the University of Southampton.
The researchers found that the percentage of patients who recovered in 10 days was about the same whether they took an antibiotic or a placebo.
“With a little bit of patience, the body will usually heal itself,” said Dr Ian Williamson, a family medicine researcher at the University of Southampton and lead author of the paper published in the 5 December issue of the Journal of the American Medical Association.
The results showed that patients should be more willing to forgo antibiotics, although they should still check with their doctors when a cold worsens into a sinus infection.
Acute sinusitis is an inflammation of the sinuses that commonly develops as a complication from a cold and is often diagnosed and treated without clinical confirmation. Allergies can also cause sinusitis, but researchers in this study focused on cases likely to be caused by bacteria.
Despite the clinical uncertainty as to a bacterial cause, antibiotic prescribing rates remain as high as 92 per cent in the United Kingdom and 85 to 98 per cent in the United States, according to background information in the article. Concerns about widespread antibacterial use include increasing antibiotic resistance in the community.
Is There A Best Antibiotic For A Sinus Infection
In most cases, a sinus infection doesnt need antibiotics it will go away on its own. Viruses are usually the cause of sinusitis. However, if yours is due to a bacterial infection, your doctor may prescribe antibiotic treatment to shorten your recovery time and relieve your symptoms. Amoxicillin, with or without clavulanate,is a first-line antibiotic prescribed for sinus infections, but your doctor will prescribe the antibiotic thats best for your condition.
Only take antibiotics if your doctor prescribes them. Dont try to self-treat your sinus infection by taking leftover antibiotics you may have on hand. Taking antibiotics when you dont need them wont help your condition and could cause serious health problems.
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Symptoms Of Bacterial Sinusitis
Symptoms of bacterial sinusitis include:
- Pressure or pain around the nose, in the forehead, in the cheeks or around the eyes. The pain often gets worse if the affected person bends forward.
- Discolored, thick nasal discharge
- Painful chewing
Good to know: Bacterial sinusitis can follow a cold or the flu, and often the symptoms occur just when it seems as if the initial infection is clearing up. In this situation it is common to start to feel better, and then to feel worse as the subsequent bacterial sinusitis develops.
If you are concerned that you or a loved one may have bacterial sinusitis, you can do a free symptom assessment using the Ada app at any time.
Antibiotics And Sinus Infections
When a sinus infection hits, it seems worse than what you remembered from the last time you had one. This may give you the idea that you need antibiotics, but most clear up without them. Antibiotics have no effect on viruses and arent recommended within the first week of developing a cold. About 70% of sinus infections go away within two weeks without antibiotics.
Consider these other forms of treatments instead of antibiotics:
- These medications are available for over-the-counter purchase. Be careful to only take these medications for a few days at most, as they can cause the return of more severe congestions.
- Over-the-counter pain relievers Aspirins, acetaminophen or ibuprofen can help relieve temporary pain.
- Saline nasal spray This is used to spray into your nose several times a day to rinse your nasal passages. It can help to prevent and treat inflammation.
Antibiotics only will be needed if the infection is severe, recurrent or persistent.
The likelihood of bacterial infection increases when:
- Symptoms last seven days or more, particularly when symptoms initially improve and then worsen.
- Mucus is thick and yellow or green in color.
- There is facial or sinus tenderness, particularly if its worse on one side of the face.
- Pain is present in the upper teeth and is worse on one side of the face.
If the infection becomes severe, recurrent or persistent, contact your provider.
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