Sinusitis and its treatment

Are antibiotics necessary to treat sinus infections and sinusitis?

For sinusitis caused by virus infection, antibiotic treatment is not required. Recommended treatments often include pain and fever medications (such as acetaminophen [Tylenol]), decongestants and mucolytics (medications that dissolve or break down mucus, for example, guaifenesin).

A bacterial infection of the sinuses is suspected when facial pain, a runny nose that resembles pus and symptoms persist for more than a week and do not respond to OTC nasal medications. Acute sinus infection by bacteria is usually treated with an antibiotic therapy aimed at treating the most common bacteria known to cause sinus infection, since it is unusual to be able to obtain a reliable culture without aspirating the sinuses.

The five most common bacteria that cause sinus infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes. Antibiotics that are an effective treatment for sinus infection should be able to kill these types of bacteria. Although amoxicillin (Amoxil) is an acceptable first antibiotic for an uncomplicated acute sinus infection, many doctors choose amoxicillin-clavulanate (Augmentin) as the first-line drug for the treatment of a suspected bacterial sinus infection, because it is usually effective against most species and strains of bacteria that cause the disease.

In individual allergic penicillin, cefaclor (Ceclor), loracarbef (Lorabid), clarithromycin (Biaxin), azithromycin (Zithkromax), sulfamethoxazole (Gantanol), trimethoprim (Bactrim, Septra) ciprofloxin (Cipro) can be used as other antibiotics as first antibiotics elections. If a patient does not improve after five days of treatment with amoxicillin, the patient may switch to one of the above medications or amoxicillin-clavulanic acid (Augmentin). In general, an effective antibiotic should be continued for a minimum of 10-14 days. However, it is not unusual that you need to treat sinus infection for 14-21 days. It is believed that some antibiotics also reduce inflammation, regardless of anitbacterial activity.

What decongestants and nasal sprays soothe or cure sinus infections or sinusitis?

Taking decongestants (pseudoephedrine) and mucolytics (guaifenesin) by mouth may be helpful to help drain sinus infection.

Treatment of chronic forms of sinus infection requires longer courses of medications, such as Augmentin, and may require a sinus drainage procedure. This drainage usually requires a surgical operation to open the blocked sinus under general anesthesia. In general, antihistamines should be avoided unless sinusitis sinusitis is considered to be due to allergies, such as pollen, dandruff or other environmental causes.

It is likely that the use of a topical nasal steroid spray helps reduce swelling in the allergic individual without drying caused by the use of antihistamines, although both are occasionally used. Oral steroids may be prescribed to reduce acute inflammation and help with chronic inflammation in cases with or without polyps and in allergic fungal sinusitis.
In many people, allergic sinusitis develops first, and later, a bacterial infection occurs. For these people, early treatment of allergic sinusitis can prevent the development of secondary bacterial sinusitis.

In rare cases or in natural disasters, fungal infections (called zygomycosis or mucormycosis) can develop in weakened people. Mortality rates of 50% -85% have been reported in patients with these sinus infections. Treatment is based on an early diagnosis followed by immediate surgical debridement, antifungal medications (mainly amphotericin B) and stabilization of any underlying health problems, such as diabetes.

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