Monday, December 5, 2022

What Antibiotic Is Prescribed For Sinus Infection

An Overview About Sinus Infection Antibiotics

Discussion with a patient with sinusitis who requests antibiotics

It is to be borne in mind that the efficacy of a particular medication may differ from one person to another. To be on the safer side, it is always advisable to take antibiotics under strict medical supervision. And irrespective of which antibiotic is prescribed, completion of the medication course as per the direction of the physician is essential to prevent recurrent sinus infections. Speaking about the side effects of taking sinus infection antibiotics, increased risk of drug resistance is the main concern. This is a serious issue as the patient will no strong respond to common antibiotics afterward.

Other reported adverse effects of taking antibiotics for sinusitis treatment are nausea, mild digestive problems, and increased chances of viral and fungal infections. It is found that half of the patients afflicted with bacterial sinusitis recover without advocating antibiotics. To sum up, these antibiotics are effective for those who really need them. So, decide whether the antibacterial medication is truly needed for sinusitis treatment or not. If the answer is yes, then proceed with the treatment strategy under strict medical supervision. Otherwise, refrain from taking medication as far as possible. After all, every allopathic treatment is associated with some health effects.

Antibiotic Overuse Leads To Antibiotic Resistance

At some point, most people have taken a course of trimethoprim/sulfamethoxazole or ciprofloxacin , two common antibiotics used for UTIs. However, in the last few years it has become clear that the likelihood these antibiotics will kill most UTIs is dropping rapidly. You may have read the recent, frightening New York Timesarticle reporting one in three uncomplicated UTIs in young healthy women are Bactrim-resistant and one in five are resistant to five other common antibiotics. Pretty scary, since we used to feel confident that writing a prescription for Bactrim was a sure recipe for cure.

How is it that we are losing the antibiotic war with bacteria? Though many things drive bacterial resistance, giving antibiotics to animals and antibiotic overuse in humans top the list.

We use a lot of antibiotics in humans too much, and not always for the right reasons. When we prescribe antibiotics for viral illnesses like a cold, the flu, or common sinusitis, we create a massive shift in the bodys bacteria for no good reason .

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Anatomy Of The Paranasal Sinuses

The paranasal sinuses comprise four pairs of sinuses that surround the nose and drain into the nasal cavity by way of narrow channels called ostia . Mucus leaving the frontal and maxillary sinuses drains through the ethmoid sinuses , so a backup in the ethmoids is likely to clog the other two types of sinuses. The sphenoid sinuses are located deep in the skull, behind the eyes. Sinusitis develops when one or more sinuses become blocked.

There are millions of bacteria in our noses, and most of the time, theyre harmless. Even when a few creep into the sinuses, they dont cause trouble, as long as they keep draining into the nose along with mucus. But if sinus drainage is blocked, glands in the sinuses continue to produce mucus, and the resulting pool of backed-up mucus provides what Dr. Metson calls the perfect culture medium. The bacteria grow out of control, causing infection, and the immune system kicks off an inflammatory response. The result: swelling, which causes and facial pain mucus buildup, which produces congestion and an influx of white blood cells to fight the bacteria, which thickens the mucus and may tint it yellow or green. Other symptoms include loss of smell or taste, cough, bad breath, fever, toothache, and fullness in the ears.

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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.

What Is The Best Medicine For Sinusitis

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What is the best medicine for sinusitis?

What is the best antibiotic for a sinus infection? Amoxicillin is acceptable for uncomplicated acute sinus infections however, many doctors prescribe amoxicillin-clavulanate as the first-line antibiotic to treat a possible bacterial infection of the sinuses. Amoxicillin usually is effective against most strains of bacteria.

What medicine will clear my sinuses? Decongestants. These medicines help reduce the swelling in your nasal passages and ease the stuffiness and sinus pressure. They come as nasal sprays, like naphazoline , oxymetazoline , or phenylephrine .

What kills a sinus infection? Generic antibiotics like amoxicillin or cefdinir can be used to stop the growth of or kill bacteria to resolve a sinus infection. Other popular antibiotics prescribed for sinus infections include Zithromax or Augmentin.

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Common Causes Of Sinus Infection

Sinus infections are caused by either viruses or bacteria, but they can be caused by fungi as well. Although is a very common condition, some people are at higher risk of developing the infection. They include people who:

  • Have abnormalities in the nasal passages, such as or a deformity

  • Have a weakened immune system

How Do Medical Professionals Diagnose Mucormycosis

  • Presumptive diagnosis is based on the patientâs history, physical exam, and the patientâs risk factors for getting a fungal infection. A definitive diagnosis is difficult.
  • Although tests such as CT or MRI may help define the extent of infections or tissue destruction, their findings are not specific for mucormycosis.
  • There are no serological or blood tests that are helpful. Growth of the fungi from a biopsy of infected tissue, accompanied by special tissue stains looking for unique structural components, may identify the fungus and help make the definitive diagnosis. This helps distinguish mucormycosis from other fungal diseases such as candidiasis and histoplasmosis.
  • However, it is still sometimes difficult to determine the specific fungal genus and species infecting the patient.
  • Consequently, mucormycosis is often a âworkingâ diagnosis that clinicians use because the supportive care and treatments for the causative fungal agents are essentially the same. Figure 2 shows a periorbital eye infection eventually diagnosed as mucormycosis.
  • Patients with underlying diseases like diabetes need their diabetes optimally controlled.
  • Patients normally on steroids or undergoing treatment with deferoxamine are likely to have these medications stopped because they can increase the survival of fungi in the body.
  • Patients may need additional surgeries and usually need antifungal therapy for an extended time period depending on the severity of the disease.
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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

    Sinus Infection Antibiotics! Why won’t my doctor write a prescription?

    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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    Is Your Sinus Infection Caused By A Virus Or Bacteria

    Physicians may not know if sinusitis is bacterial or viral, because the diagnosis is typically done by observing symptoms. Symptoms include:

    • Nasal congestion
    • Thick nasal or post-nasal drainage

    Sometimes other tests such as computed tomography scan or cultures are used to help make the diagnosis.

    Despite the recommendations that antibiotic use be judicious, they are still overused for sinusitis, according to many physicians who specialize in treating sinus problems.

    Some physicians say they give patients with sinusitis a prescription for antibiotics, and recommend they wait three to five days before filling it, and only fill it if symptoms are not better by then. A can be used to help relieve your symptoms and promote drainage.

    The longer symptoms last, the more likely a sinus problem is to be a bacterial infection, some experts say.

    What Is A Sinus Infection

    The sinuses are cavities in the head that are filled with air. These air-filled pockets are lined with a very thin layer of mucus that functions to collect particles from the air that are breathed in, such as dust, germs, or other particles.

    Very small hair-like projections function to sweep the mucus, along with any particles trapped inside of the mucus. The germ- or dirt-filled mucus then slides down the back of the throat and into the stomach where stomach acid works to kill any germs.

    When a sinus infection occurs, this natural process involving mucus flow is blocked.

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    Welcome To Silver Sinus

    Health care providers report nearly 32 million cases of chronic sinus infections to the Centers for Disease Control and Prevention annually. Even more startling is that Americans spend $5.8 billion each year on health care costs related to sinus infection treatment.

    Most of this money is spent on doctor consultations and ultimately on the antibiotics that doctors like to prescribe. Unfortunately, antibiotics donât address the cause of most chronic sinusitis. This process leads to a frustrated consumer who is still suffering from the same chronic sinus infection symptoms that they had hoped to cure. If you have been through routine and are ready for a change, then read on.

    What Is A Urinary Tract Infection

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    If you have ever experienced the frequent urge to go the bathroom with painful and burning urination, you have probably experienced a urinary tract infection . UTIs are one of the most common types of infections, accounting for over 10 million visits to health care providers each year. Roughly 40% of women experience a UTI at some time, and in women, it is the most common infection. Healthcare costs related to UTIs exceed $1.6 billion per year.

    A urinary tract infection can happen anywhere along your urinary tract, which includes the kidneys , the ureters , the bladder , or the urethra . Most UTIs occur in the bladder and urethra. Common symptoms include frequent need to urinate, burning while urinating, and pain in lower abdomen area.

    There are different types of UTIs based on where the bacteria goes. A lower urinary tract infection occurs when bacteria gets into the urethra and is deposited up into the bladder â this is called cystitis. Infections that get past the bladder and up into the kidneys are called pyelonephritis.

    Urinary tract infection symptoms may include:

    • Pain or burning upon urination
    • A frequent or urgent need to urinate
    • Passing small amounts of urine
    • Blood in the urine or or pink-stained urine
    • Urines that looks cloudy
    • Strong-smelling urine
    • Pain, cramping in the pelvis or pubic bone area, especially in women

    Upper UTIs which include the kidney may also present with symptoms of fever, chills, back or side pain, and nausea or vomiting.

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    Sudafed For Sinus Infection

    Sudafed is a brand name for a powerful decongestant, pseudoephedrine used widely for treating sinus congestion. This works by shrinking the dilated blood vessels in the nose that can cause stuffiness. Some variants of Sudafed are prepared with a combination of ibuprofen that can provide relief from headaches and muscle aches while some other variants are prepared with other nasal congestants that provide more effective relief.

    Has Levaquin Been Discontinued

    Yes. In December 2017, Janssen Pharmaceuticals pulled Levaquin, the brand name of levofloxacin, and Floxin Otic, the brand name of ofloxacin ear drops, from production. Janssen said that it decided to discontinue Levaquin due to the broad availability of alternative antibiotics. However, there were several lawsuits over severe side effects caused by the antibiotic. These lawsuits came from Levaquin patients who experienced serious side effects, primarily aortic aneurysms and tendon ruptures, after taking the drug and claimed that Janssen Pharmaceuticals marketed the drug despite its potentially dangerous side effects.

    Prior to these lawsuits, the FDA had issued a black box warning for severe adverse effects linked to Levaquin, Cipro, Avalox, and other fluoroquinolones. A black box warning is the most serious type of warning the FDA will issue before completely banning a medication.

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    Sinusitis In The Real World

    How effective are antibiotics for patients diagnosed not by sinus x-rays or CTs, but by signs and symptomsas we typically do in daily practice?

    A meta-analysis of 13 randomized controlled trials found that sinusitis improved without antibiotics, but it included trials in which patients were recruited based on results of imaging studies and cultures, which are not normally used in primary care clinical practice. That study compared antibiotic treatment to placebo for acute uncomplicated sinusitis 35% of placebo-treated patients were clinically cured by 7 to 12 days and 73% were improved after 7 days. Antibiotic therapy increased cure rates by 15% and improvement rates by 14%, yielding a number needed to treat of 7 to achieve 1 additional positive outcome at 7 days.

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    Risk Of Unnecessary Antibiotics For Sinus Infections

    New Treatments for Chronic Sinusitis

    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.

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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:

  • You have symptoms of a bacterial infection and you have not gotten better after 10 days, even with home treatment.
  • You have severe symptoms such as severe headache or facial pain, or you have other problems, such as pus forming in your sinus cavities.
  • You have had sinusitis for 12 weeks or longer .
  • You have a fever longer than 3-4 days.
  • Your symptoms get worse after initially improving.
  • 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.

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    Recommendations For Nonantimicrobial Therapy

    Intranasal steroids have not been conclusively shown to be of benefit in cases of acute sinusitis. One meta-analysis of 4 double-blind, placebo-controlled trials of intranasal corticosteroid treatment in acute rhinosinusitis supports its use as monotherapy or as an adjuvant therapy to antibiotics. However, a randomized, controlled trial of antibiotics and intranasal steroid showed no treatment benefit of intranasal steroids, either alone or with antibiotics.

    In a literature study, van Loon et al concluded that only limited evidence exists regarding the efficacy of intranasal corticosteroids in relieving the symptoms of recurrent acute rhinosinusitis. The best evidence, according to the investigators, came from a single study, which had a low bias risk but only moderate directness of evidence according to that report, intranasal corticosteroids may shorten the time needed to achieve symptom relief.

    No available data suggest that antihistamines are beneficial in acute sinusitis. In fact, antihistamines may cause harm by drying mucous membranes and decreasing clearance of secretions. Antihistamines are beneficial for reducing ostiomeatal obstruction in patients with allergies and acute sinusitis however, they are not recommended for routine use for patients with acute sinusitis. Antihistamines may complicate drainage by thickening and pooling sinonasal secretions.

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    Amoxicillin Dosage For Helicobacter Pylori Eradication

    Helicobacter pylori is a bacteria that infects the stomach lining. Many people with an H. pylori infection show no symptoms. However, the infection can damage the stomach lining, leading to gastrointestinal complications such as gastritis , stomach ulcers, duodenal ulcers, and stomach cancer.

    Treatment consists of combining multiple drugs to eradicate the infection. Dual therapy combines very high doses of amoxicillin with a second drug to reduce stomach acid, usually a proton pump inhibitor, such as lansoprazole. Triple therapy combines high doses of amoxicillin along with another antibacterial drug and a third drug to reduce stomach acid. Quadruple therapy adds bismuth subsalicylate to triple therapy regimens to reduce swelling and protect the stomach lining.

    • Standard adult dual therapy dosage for H. pylori eradication: 1 g taken three times per day for 14 days

    • Standard adult triple therapy or quadruple therapy dosage for H. pylori eradication: 1 g taken twice per day for five to 14 days

    • Maximum adult dosage: 3 g per day

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