When To Use Antibiotics For Sinusitis
No doubt, antibiotic medications are formulated for killing bacteria, but they are not effective against virus, fungi, and allergens. With a sinusitis case, bacteria are one of the probable causes, and there are also high chances of allergies, fungal or viral infections. For those with viral and fungal attacks, there is no point in adopting antibacterial therapy. Unfortunately, some patients afflicted with sinusitis self administer antibiotics without knowing the actual cause. Also, it is a common practice to prescribe antibiotics for sinusitis. And the outcome is, persistent symptoms and increased risk of bacterial resistance to the antibiotic medication.
Proper diagnosis of sinus infection is thus a necessity before starting antibacterial treatment for sinusitis. It is proceeded by culturing the mucus from affected sinuses and examining it for presence of microorganisms. In addition, imaging studies of the paranasal sinuses are performed to identify any abnormal changes in them. Once it is confirmed that bacteria cause the problem, the physician may recommend antibacterial formulation for sinus infection. The antibiotics either stop further multiplication of bacteria or kill them. In either of the cases, taking medication and strengthening the immune system quicken the recovery period.
How To Treat A Sinus Infection Without Antibiotics
Before you consider antibiotics, a sinus infection can be treated without leaving at home. Some of the home remedies to treat a sinus infection without antibiotics include:
What Medications Are Used To Treat Sinus Infections
First and foremost, if you are suffering from an active bacterial sinus infection you may be treated with antibiotics. Depending on whether you have acute sinusitis or chronic sinusitis will determine your course of therapy.As acute sinusitis may require 10 -14 days of antibiotic therapy chronic sinusitis may need to be treated for up to 30 days with medication.Remember Most cases of sinusitis are caused by viruses such as the common cold and will clear up within 10 or so days. In this case, antibiotics will not be helpful as antibiotics kill bacteria not viruses. Based upon your symptoms, medical history and physical examination your doctor will help determine if antibiotics are necessary.
Sinus headaches hurt. Sometimes the pain and pressure can make basic everyday activities impossible to do. So many times those suffering from sinusitis will take an over the counter medication such as acetaminophen or ibuprofen . Make sure to follow the labeled directions and see your doctor if your symptoms havent improved after a week or if they worsen.
Aerosolized antibiotics, steroids and antifugal treatments:
These may be administered through an aerosol or a nasal rinse. Frequently a compounding pharmacy is required to create this rinse.
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Antibiotic Treatment For Sinusitis
Antibiotics are labeled as narrow-spectrum drugs when they work against only a few types of bacteria. On the other hand, broad-spectrum antibiotics are more effective by attacking a wide range of bacteria, but are more likely to promote antibiotic resistance. For that reason, your ear, nose, and throat specialist will most likely prescribe narrow-spectrum antibiotics, which often cost less. He/she may recommend broad-spectrum antibiotics for infections that do not respond to treatment with narrow-spectrum drugs.
Antibiotics Sinus Infections And Probiotics
Millions of people are diagnosed with sinusitis each year, for which they are prescribed antibiotics. Those with frequent sinus infections may wind up taking antibiotics repeatedly. However, there is a growing concern in the medical community that antibiotics, especially when taken frequently, may be causing harm.
Antibiotics are amazingly effective in treating infections caused by harmful bacteria. They can be a lifesaver. But antibiotics dont just kill or inhibit the growth of harmful bacteria, they also kill good bacteria living in the body and this can lead to health problems. Bacteria can also develop antibiotic resistance.
While recent research is showing the harms of frequent use of antibiotics, especially to our microbiome, other exciting research is pointing a way forward. This is using beneficial bacteria to reduce or even eliminate the use of antibiotics for sinusitis and some other types of infections.
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When Do I Really Need Antibiotics For A Sinus Infection
When do I really need antibiotics for a sinus infection? is a question many patients have when suffering from bothersome sinus and allergy problems. While sinus infections can be quite painful, antibiotics often do not help in treating the condition.
Sinus infections affect approximately 37 million people in the U.S. each year and can be caused by:
- Nasal polyps or deviated septum causing nasal obstruction
The majority of sinus infections are viral in nature, and antibiotics do not cure viral infections. Taking antibiotics for viral infections also will not:
- Keep you from being contagious to others
- Relieve symptoms or make you feel better
In order to distinguish a bacterial sinus infection from an infection caused by a virus or other contributing factor, your doctor will observe your symptoms and possibly conduct other tests, such as a CT scan or cultures.
Antibiotics are only effective on bacterial infections, and even in cases involving bacteria, the body can often cure itself of mild or moderate infections within a few days.
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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Reason Of Using Sinusitis Antibiotics
Particularly, sinusitis antibiotics are used when one does not get any good results with home treatment. If sinusitis symptoms are quite mild and very complicated, then use of antibiotics can be effective. Amoxicillin is an effective sinusitis antibiotic which often is prescribed to cure chronic sinusitis. It contains some side effects. People, who are diagnosed with mononucleosis, should avoid using this medication. Though, it is not so with all sinusitis antibiotics, but some of them work effectively. These are very safe and influential. Antibiotics have capability to eradicate sinusitis from the root and around 90/100 people have got great results by using this medication.
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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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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Algorithm For Use Of Antibiotics In Acute Sinusitis
Adapted from Chow AW, Benninger MS, Brook I, et al: IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clinical Infectious Diseases 54 :10415 .
In exacerbations of chronic sinusitis in children or adults, the same antibiotics are used, but treatment is given for 4 to 6 weeks. The sensitivities of pathogens isolated from the sinus exudate and the patients response to treatment guide subsequent therapy.
Sinusitis unresponsive to antibiotic therapy may require surgery to improve ventilation and drainage and to remove inspissated mucopurulent material, epithelial debris, and hypertrophic mucous membrane. These procedures usually are done intranasally with the aid of an endoscope. Chronic frontal sinusitis may be managed either with osteoplastic obliteration of the frontal sinuses or endoscopically in selected patients. The use of intraoperative computer-aided surgery to localize disease and prevent injury to surrounding contiguous structures has become common. Nasal obstruction that is contributing to poor drainage may also require surgery.
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Common Antibiotics For Sinus Infections
Antibiotics may be prescribed when symptoms of a sinus infection warrant such treatment. Common antibiotics for sinus infection include:
- 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.
Sinus Anatomy And Function
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2. McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA. 1995 273:2149.
3. Bamberger DM. Antimicrobial treatment of sinusitis. Semin Respir Infect. 1991 6:7784.
4. Dingle JH, Bodger GF, Jordan WS Jr. Illness in the home: a study of 25,000 illnesses in a group of Cleveland families. Cleveland Press: Case Western Reserve University, 1964:347.
5. Wald ER. Sinusitis in children. N Engl J Med. 1992 326:31923.
6. Hinriksdottir I, Melen I. Allergic rhinitis and upper respiratory tract infections. Acta Otolaryngol Suppl. 1994 515:302.
7. Gwaltney JM Jr, Scheld WM, Sande MA, Sydnor A. The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J Allergy Clin Immunol. 1992 90:45761.
8. Winther B, Gwaltney JM. Therapeutic approach to sinusitis: anti-infectious therapy as the baseline of management. Otolaryngol Head Neck Surg. 1990 103:8769.
9. Evans FO Jr, Sydnor JB, Moore WE, Moore GR, Manwaring JL, Brill AH, et al. Sinusitis of the maxillary antrum. N Engl J Med. 1975 293:7359.
10. Evans KL. Diagnosis and management of sinusitis. BMJ. 1994 309:141522.
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Which Types Of Doctors Treat Sinusitis And Sinus Infections
- Many sinus infections can be treated by your primary care physician or an Internal Medicine doctor.
- However, it is not unusual to consult an ENT specialist,
- Infectious disease specialist,
- Allergist or Immunologist.
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.
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:
Antibiotics For Sinus Infections
Antibiotics are medicines that have anti-bacterial properties. This means that they are drugs that can kill bacteria or prevent them from multiplying within our body. However, they are ineffective against viruses which cause the common cold and viral influenza.
When the immune system in our body is healthy, it is able to fend off bacterial invasions effectively. The antibodies and white blood cells can usually destroy harmful bacteria before they can multiply sufficiently to cause symptoms of an illness. Even when symptoms do occur, a healthy body is still able to fight off the infection. But when our immune system is impaired, the body is unable to contain the bacterial infection and extra help is needed. This is where antibiotics come in.
Classes of Antibiotics
The following are the most common classes of antibiotics in use today:
Antibiotics are classified as narrow-spectrum drugs when they work against only a few types of bacteria. Broad-spectrum antibiotics, on the other hand, affect many types of bacteria. But, the use of broad-spectrum antibiotics presents the danger of promoting antibiotic resistance. For that reason, narrow-spectrum antibiotics, which usually cost less, are prescribed whenever possible. Broad-spectrum antibiotics are generally not prescribed unless the condition of the patient warrants it.
Which is the best antibiotic for sinus infection?
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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.
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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When Do We Need Antibiotics For Sinus Infection
Antibiotics are not needed for many sinus infections, but your doctor can decide if you need an antibiotic. You doctor may recommend antibiotics if:
Most sinus infections usually get better on their own without antibiotics. When antibiotics arent needed, they wont help you, and their side effects could still cause harm. Side effects can range from minor issues, like a rash, to very serious health problems, such as antibiotic-resistant infections and C. diff infection, which causes diarrhea that can lead to severe colon damage and death.