What Happens When Unnecessary Antibiotics Are Prescribed
Research shows that even bacterial infections can clear up on their own without antibiotics within one to two weeks. This means that the majority of the time, antibiotics are unnecessarily prescribed. Of all sinus infections, 85% clear up on their own, while only 15% do not. This 15% is the population that needs antibiotics.
Consuming antibiotics, even when you need them, increases side effects and bacterial resistance rates. This means that the more antibiotics prescribed, the more the bacteria will adapt to become resistant to that specific antibiotic. And there are only so many antibiotics to go around, so resistance should not be taken lightly. Thats why the overprescription of antibiotics is a public health emergency.
What Are Complications Of Sinus Infection Or Sinusitis
While serious complications do not occur frequently, it is possible for a sinus infection to cause a direct extension of infection into the brain through a sinus wall, creating a life-threatening emergency .
In addition, other adjacent structures can become infected and develop problems, such as osteomyelitis of bones in the skull and infection around the eye . Rarely, these infections may cause death. The most susceptible individuals to complications are patients with suppressed immune systems, diabetes, and relatively rarely from multiple trauma injuries that may occur in natural disasters.
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.
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Do Antibiotics Benefit Any Subgroups
The investigators also analyzed the prognostic value of specific signs and symptoms to answer the question: Is there any subgroup of patients who might benefit more from antibiotic treatment?
Duration. Patients with a longer duration of symptoms, more severe symptoms, or increased age took longer to cure, but were no more likely to benefit from antibiotic treatment than other patients.
Symptoms, such as a previous common cold, pain on bending, unilateral facial pain, tooth pain, and purulent nasal discharge did not have any prognostic value.
Only one signpurulent discharge noted in the pharynx on examinationwas associated with a higher likelihood of benefit from treatment with antibiotics, but the NNT was still 8 in this group. Patients with symptoms for 7 days or longer were no more likely to respond to antibiotics than those with symptoms for fewer than 7 days.
Sinus Infection Medication For Bacterial Causes
Bacterial sinus infections are caused by large amounts of foreign bacteria creating colonies in the sinuses, causing inflammation and infection. This happens when you touch your nose, eyes, or ears too often without washing your hands frequently.
There are several bacterial infections that may result in a sinus infection if symptoms worsen over time.
If over-the-counter medications are not working, you may need to seek a prescription for antibiotics as a sinus infection medication. Luckily, our sister site PlushCare gives you access to top doctors who can write prescriptions for many medications, including antibiotics for sinusitismake an appointment through PlushCare to get started.
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Types Of Sinus Infections: Chronic Vs Acute
There are four types of sinus infections. These classifications depend on the length and frequency of the infection:
- Acute sinusitis.This type of sinus infection lasts only for a short time, defined by the American Academy of Otolaryngology as less than 4 weeks. This short-term infection is usually part of a cold or other respiratory illness. It may also be caused by a bacterial infection .
- Subacute sinusitis. A subacute sinus infection lasts between 4 and 12 weeks .
- Recurrent acute sinusitis. An acute sinus infection is considered recurrent if the infection returns four or more times within a year, with each infection lasting 7 days or more.
- Chronic sinusitis.Chronic sinus infections last for more than 12 weeks or continue to recur.
Many sinus infection symptoms are common in both acute and chronic forms. Seeing a doctor is the best way to learn if you have an infection, find the cause, and get treatment.
For cases of acute bacterial sinus infections, these symptoms last at least 10 days without improving, or they worsen within 10 days after seeming to improve. In this case, its important to talk with a doctor, such as a general practitioner or an ear, nose, and throat doctor , to get a diagnosis and treatment plan.
Learn more about the symptoms of a sinus infection below.
Recommended Dosage Of Prednisone
Your doctor will likely recommend that you inhale the steroid through the nose. Inhaling steroids delivers the steroids directly to the inflamed parts of your tissues. But if you have polyps in your nose, they may block your nasal passages and stop the steroid from reaching the inflamed areas. If inhaled steroids prove not to be effective in giving you desired results, a your doctor may consider giving you a short course of oral Prednisone. Taking Prednisone for about a week is enough to reduce the size of polyps and reduce overall nose inflammation. Since inflammation is reduced and polyps shrink in size, inhaled steroids can reach their target easily and deliver the best results. Patients are most commonly prescribed 60mg of Prednisone per day, but the dosage may vary, depending on the condition of the patient and their individual response to the drug.
Most doctors avoid using oral steroids, this is likely because these steroids travel into the patients blood stream and in turn oneâs entire body becomes exposed to the medicine. On the contrary, topical and inhaled steroids are only exposed to the sinuses and nose. Patients taking oral steroids are more susceptible to developing side effects. These side effects may include mood swings, increased blood pressure and glaucoma. However, no serious side effects should occur as long as Prednisone is taken in low dosage for a short period of time, supervised by a medical professional.
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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.
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.
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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.
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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Related Resources For Sinus Infections
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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
When Antibiotics Are In Order
The main reason to prescribe antibiotics is for patient comfort, Dr. Sindwani says. The medical field used to be more convinced than it is today than untreated sinusitis would inevitably become a chronic issue, he says.
We dont think that way as much, he says. We dont know that an untreated acute sinusitis, if left untreated, will grumble along and cause people to have a chronic sinus infection.
Some people think thats two separate things, with chronic sinusitis more likely due to underlying issues like allergies or immune problems.
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Sinus Infection Definition And Facts
- Sinusitis or sinus infection is inflammation of the air cavities within the passages of the nose.
- Sinusitis can be caused by infection, allergies, and chemical or particulate irritation of the sinuses.
- The fastest way to get rid of a sinus infection can include medications, home remedies, alternative therapies, and surgery.
- Most people do not spread sinus infections to other people.
- Sinusitis may be classified as acute sinus infection, subacute sinus infection, chronic sinus infection, infected sinusitis, and noninfectious sinusitis.
- Sinusitis signs and symptoms include
How Often Are Sinus Infection Medications Used
At least 35 million Americans contract sinusitis each year and are all too familiar with the discomfort associated with sinus infections that require medication.
If you have a sinus infection and want to know how to get rid of it, or if youre lucky enough not to have one and want to prevent one from happening, there are several measures you can take.
If youre seeking out sinus infection medication, its important to know the symptoms, causes, and solutions to your discomfort.
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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:
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What Tests Diagnose The Cause Of Sinus Infections And Sinusitis
Sinus infection is most often diagnosed based on the history and examination of a doctor. Because plain X-ray studies of the sinuses may be misleading and procedures such as CT and MRI scans, which are much more sensitive in their ability to diagnose a sinus infection, are so expensive and not available in most doctors’ offices, most sinus infections are initially diagnosed and treated based on clinical findings on examination. These physical findings may include:
- redness and swelling of the nasal passages,
- purulent drainage from the nasal passages ,
- tenderness to percussion over the cheeks or forehead region of the sinuses, and
- swelling about the eyes and cheeks.
Occasionally, nasal secretions are examined for secreted cells that may help differentiate between infectious and allergic sinusitis. Infectious sinusitis may show specialized cells of infection while allergic sinusitis may show specialized white blood cells of allergy . Physicians prescribe antibiotics if the bacterial infection is suspected. Antibiotics are not effective against viral infections many physicians then treat the symptoms.
In addition, both rigid and flexible endoscopy has been used to obtain diagnostic material from sinuses. These procedures are usually done by an otolaryngologist under topical and local anesthesia. Occasionally, there may be a need to sedate the patient. Some investigators suggest that endoscopy specimens are comparable to those obtained by needle puncture.
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What Antibiotics Help Sinus Infections
Antibiotics are prescribed to help actively kill bacteria so your body can more easily handle the effects of infection and create a more effective immune response. There are a variety of antibiotics that doctors can prescribe for sinusitis. Each type of antibiotic kills bacteria and affects the body differently. Your doctor will prescribe an antibiotic based on your symptoms and medical history.
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.
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How Do You Get Rid Of A Sinus Infection Fast
You can treat a sinus infection at home or with OTC medications for symptom relief, and/or a prescription antibiotic medication, in the case of a bacterial infection. Stay hydrated, use a humidifier, and sleep at an incline to help resolve your sinus infection quickly. Consult your healthcare provider to see if you need an antibiotic.
Are Doctors Prescribing Antibiotics Too Often For Sinus Infections
- Date:
- University of Georgia
- Summary:
- Sinus infections are one of the most common reasons patients walk out of the doctors office with an antibiotic prescription in hand. The problem is that bacteria causes only about one-third of sinus infections, which means most patients are inappropriately receiving antibiotics.
Sinus infections are one of the most common reasons patients walk out of the doctorâs office with an antibiotic prescription in hand. The problem is that bacteria causes only about one-third of sinus infections, which means most patients are inappropriately receiving antibiotics.
To curb unnecessary antibiotic prescribing, physician and University of Georgia researcher Mark Ebell developed a clinical decision rule for diagnosing sinus infections, or acute rhinosinusitis. In a study appearing in the Annals of Family Medicine, Ebell presents a series of simple clinical rules that integrate patient symptoms and simple lab tests to accurately detect acute bacterial rhinosinusitis.
âA lot of the signs and symptoms of a bacterial sinus infection can be similar to those of a viral respiratory infection,â said Ebell, who is a professor of epidemiology at UGAâs College of Public Health. âIt can be difficult to distinguish between the two just using individual signs and symptoms.â
Ebellâs next plan is to perform a randomized clinical trial to test the effectiveness of the point score system, including the use of a CRP test, in clinical practice.
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