Ways To Recognize Serious Signs Of Sinus Infections
#1: Duration
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.
#4: Fever
A fever can be caused by both viruses and bacteria. So how do you differentiate between the two?
What Are The Best Antibiotics For Sinus Infection Do Doctors Prescribe For You
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.
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.
Personal Stories About Antibiotics For Sinusitis
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I’ve had sinusitis a few times. So when my doctor suggested I take an antibiotic, I asked him if I really needed it. He said I would probably get better faster if I took the medicine. But I know from the other times that I’ll probably be okay in a week or so anyway. So we decided to wait and see instead of trying antibiotics.
I can’t wait to feel better. It seems like I’ve had bad sinus pain for the longest time. It’s been at least 2 weeks. Nasal sprays aren’t helping. I’m going to ask my doctor for antibiotics.
David, 28
I thought I just had a bad cold, but my doctor says I have sinusitis caused by a bacterial infection. I’ve been doing all the right things at home, but it isn’t going away. I think antibiotics are the next step for me.
Carmen, 50
I thought I’d get my doctor to give me some antibiotics for my sinusitis. Then I’d be over it sooner. But it turns out that antibiotics won’t help me, since my sinusitis started as a cold. I didn’t know that antibiotics don’t always work. I’m going to wait it out instead.
John, age 52
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Nice Is Advising Healthcare Professionals To Tell Their Patients That A Sinus Infection Will Likely Clear
27 October 2017
The final guidance, developed with Public Health England, makes recommendations for treating acute sinusitis.
In most cases, people who have sinusitis will start to feel better within two-to-three weeks. The infection is usually viral, which means antibiotics should not be routinely prescribed, the guidance says.
Instead, NICE says healthcare professionals should advise their patients on how to manage their aches and pains with paracetamol.
They should also tell them that there is no evidence oral decongestants or steam inhalation will make any difference. And inform them that they should seek further medical advice if their symptoms get worse, or last for more than three weeks.
Dr Tessa Lewis, GP and chair of the managing common infections guidance committee, said: We know that most people with sinus infections will recover in a couple of weeks without needing any antibiotics, but that doesnt mean we should be sending them home without any information or advice.
Health professionals can help their patients cope with this infection and the sometimes unpleasant symptoms it can cause. They should tell them that theyll probably be feeling this way for a while, and that unless they are very unwell, the best thing to do is to take paracetamol and take it easy.
Professor Gillian Leng, deputy chief executive at NICE said:Antibiotic resistance is one of the greatest dangers to our health, which is why we must all work together to fight it.
How Can You Treat Sinusitis Without Antibiotics
Whether sinusitis is caused by bacteria or by a virus, most people get better even if they don’t take antibiotics.1 Home treatment for sinusitis can help relieve your symptoms. Here are some things you can do:
- Drink plenty of fluids to thin your mucus.
- Apply moist heat to your face for 5 to 10 minutes. Do this at least 3 times a day.
- Breathe warm, moist air from a steamy shower, a hot bath, or a sink filled with hot water.
- Use saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria. You can buy saline nose drops or sprays at a pharmacy or make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled. You may also find it helpful to gargle with warm salt water.
- Ask your doctor if you can take over-the-counter medicines such as pain relievers and decongestants to help you feel better. Be safe with medicines. Read and follow all instructions on the label.
- If you need to blow your nose, do it gently. Blowing your nose too hard may force thick mucus back into your sinuses. Keep both nostrils open when you blow your nose.
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When To Worry About Your Lingering Sinus Infection
Philip Scolaro, MD
Sinus infections have a way of making time stand still in a bad way. When youre constantly congested, battling headaches, and feeling sinus pressure, even a short duration of sickness can feel like its never going to end.
What if it doesnt? If your lingering sinus infection becomes chronic, it may be time for more aggressive treatment.
Heres what you need to know about sinus infections and when its time to take the next step in treatment.
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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What Are The Most Common Antibiotics Used For Sinusitis
Amoxicillin remains the drug of choice for acute, uncomplicated bacterial sinusitis. Amoxicillin is most effective when given frequently enough to sustain adequate levels in the infected tissue. While often prescribed twice daily, it is even more effective if taken in 3 or 4 divided doses. Amoxicillin is typically prescribed for 7-10 days at a time. While it is critical to finish the entire 10 day course of antibiotics when treating strep throat, there is evidence that shorter courses of treatment may be sufficient for most cases of sinusitis. Amoxicillin is closely related to the parent compound penicillin and should not be prescribed in patients who are penicillin allergic.
Cephalosporins and Augmentin are considered broad-spectrum antibiotics because they have enhanced effectiveness against a wider range of bacteria, including those that are resistant to ordinary penicillin or amoxicillin. If the patient does not improve within the first week on amoxicillin, a change to Augmentin or to a cephalosporin such as Ceftin, Cefzil, Omnicef, or Suprax is reasonable. Although these drugs have a similar mechanism of action to penicillin, they generally can be taken in adequate doses once or twice daily. These medications should be used with extreme caution in patients with a history of penicillin allergy, as cross-reaction may occur.
Additional resources:
Will My Sinus Infection Clear Up On Its Own
The first few weeks of the common cold arent fun, but the acute sinusitis that can pop up afterwards doesnt help either. Sinus congestion and the common cold, unfortunately, go hand in hand. Acute sinusitis frequently is caused by the common cold, but also can be caused by allergies and bacterial and fungal infections.
Sinus infections are caused when the cavities around your nasal passages become inflamed and swollen, which eventually interferes with drainage and causes mucus to build up. This tends to get annoying, because it makes breathing through the nose difficult. It also affects the area around your eyes and face, and can cause a throbbing headache.
When a sinus infection hits, its always 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 percent of sinus infections go away within two weeks without antibiotics.
Consider these other forms of treatments instead of antibiotics:
- 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. They can help to prevent and treat inflammation.
Antibiotics only will be needed if the infection is severe, recurrent or persistent.
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Risk Of Unnecessary Antibiotics For Sinus Infections
Taking unnecessary antibiotics for a sinus infection is not only ineffectual, but can actually be harmful to the patient. Risks of taking unneeded antibiotics include:
- Increased chance of getting an antibiotic-resistant infection at a later time
- Destruction of healthy stomach bacteria, which can allow harmful bacteria to grow
- Possible side effects, such as upset stomach, rash, or dizziness
- Allergic reaction
According to studies conducted by the American Academy of Allergy, Asthma, and Immunology , 60-70% of patients with sinus infections fully recover without the use of antibiotics. Additional research shows that almost 90% of U.S. adults diagnosed with acute sinusitis are prescribed antibiotics.
This overuse of antibiotics for sinus infections, as well as other conditions, can lead to antibiotic resistance, a state in which bacteria change over time as a reaction to antibiotic treatment, in order to survive and multiply, thus making the antibiotics less effective.
How Is Sinus Infection Diagnosed
Diagnosis depends on symptoms and requires an examination of the throat, nose and sinuses. Your allergist will look for:
- Redness
- Discolored nasal discharge
- Bad Breath
If your sinus infection lasts longer than eight weeks, or if standard antibiotic treatment is not working, a sinus CT scan may help your allergist diagnose the problem. Your allergist may examine your nose or sinus openings. The exam uses a long, thin, flexible tube with a tiny camera and a light at one end that is inserted through the nose. It is not painful. Your allergist may give you a light anesthetic nasal spray to make you more comfortable.
Mucus cultures: If your sinus infection is chronic or has not improved after several rounds of antibiotics, a mucus culture may help to determine what is causing the infection. Most mucus samples are taken from the nose. However, it is sometimes necessary to get mucus directly from the sinuses.
Knowing what kind of bacteria is causing the infection can lead to more effective antibiotic therapy. A fungus could also cause your sinus infection. Confirming the presence of fungus is important. Fungal sinus infection needs to be treated with antifungal agents, rather than antibiotics. In addition, some forms of fungal sinus infection allergic fungal sinus infection, for example do not respond to antifungal agents and often require the use of oral steroids.
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When Is A Z
Spoiler alert: its not! Because its so easy to use, the Z-Pak used to be a go-to prescription for sinus infections. But it turns out that only a minority of these prescriptions are appropriate because the majority of sinus infections are viral and not bacterial. In fact, studies have found that about a third of antibiotic prescriptions for sinus infections, sore throats, and ear infections arent even necessary. Overprescribing antibiotics increases the chance that bacteria will become resistant to them and disrupt the gut bacterial flora for months. Indeed, azithromycin is no longer recommended for bacterial sinus infections due to the risk of resistance.
If you have a sinus infection, expect to feel lousy for several days. After all, your body is waging war against an infection. You might experience:
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A runny nose
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A sore throat
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A cough
Youre also likely to feel more tired and achy and maybe even experience a low-grade fever. Most people improve within a week, but symptoms can last up to 2 weeks. Coughs can linger for a week after that.
Treating a sinus infection boils down to whether its viral or bacterial. Colds, for example, are viral. And antibiotics like the Z-Pak are not effective against viral infections. In fact, viral sinus infections have no cure. Treatment is aimed at managing symptoms and includes:
If you still dont feel better, your healthcare provider may suggest nasal or lung inhalers for other symptoms.
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Diarrhea
Rare Cases Can Turn Serious
Antibiotics also can help ward off rare but potentially dangerous complications that arise when a sinus infection spreads to the eyes or brain, Dr. Sindwani says.
Complications around the eyes are the more common of the two. These complications can cause redness, swelling around the eyes and reduced vision, and even lead to blindness in a severe form known as cavernous sinus thrombosis. Serious cases are immediately treated with IV antibiotics. Patients are usually admitted to the hospital for a CT scan to see if fluid needs to be drained, Dr. Sindwani says.
Also in rare cases, sinus infections in the rear center of ones head can spread into the brain. This can lead to life-threatening conditions like meningitis or brain abscess, Dr. Sindwani says.
Before antibiotics, people would die from sinusitis, he says. But he emphasizes that such complications are unlikely. In most cases, the bacterial infection goes away, especially if you dont have underlying medical problems.
Its important to monitor your symptoms if you suspect a sinus infection. If the condition lingers or worsens, call your doctor.
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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.
When Do You Really Need Antibiotics For That Sinus Infection
- By Monique Tello, MD, MPH, Contributor
It was February, and clinic was teeming with respiratory infections of all kinds: mostly the common cold, but also bronchitis, pneumonia, and sinus infections. The patients were coming in usually thinking that they needed antibiotics for their sinus infection, or another respiratory infection.The first patient on my schedule was a healthcare provider with sinus infection written down as her main issue.* Shed had about two weeks of nasal and sinus congestion which she blamed on a viral upper respiratory infection . Her two young kids had been sick with colds all winter, so she wasnt surprised to have these symptoms, along with endless postnasal drip and a cough.
Her congestion had improved a bit at one point, and she thought that she was finally getting better. But then, the day before her appointment, she awoke with throbbing pain between her eyes, completely blocked nasal passages, and, more concerning to her, green pus oozing from her left tear duct. She had body aches, chills, and extreme fatigue.
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