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.
How To Treat Sinus Infections Without Antibiotics
While sinus infections caused by viruses, allergies, or other non-bacterial factors may not require antibiotics, they still cause the same symptoms which make you feel sick.
Symptoms of a sinus infection include:
- Nasal congestion
- Pain or tenderness around the eyes, cheeks, or forehead
- Thick nasal or post-nasal drainage
Taking steps to alleviate your sinusitis symptoms is often the best treatment to lessen your discomfort.
Sinus infection treatment options include:
- Drink plenty of fluids
- Rest, especially the first few days, to help your body fight the infection
- Moisturize the air with a cool-mist vaporizer
- Elevate your head while sleeping to decrease post-nasal drip
- Take warm showers or baths, as steam can soothe your sore throat and loosen mucus
- Gargle with warm salt water for a sore throat
- Use saline nasal spray or nasal irrigation kit to alleviate congestion
- Use over-the-counter treatments, such as nasal drops and sprays or pseudoephedrine pills, as your doctor recommends them
What Not to Do for a Sinus Infection
You should always follow your doctors instructions when you are diagnosed with a sinus infection.
- Ask for antibiotics if your doctor feels they are unnecessary
- Take antibiotics that are prescribed for someone else
- Skip doses of your antibiotics or stop taking your antibiotics early when your doctor prescribes them
- Save antibiotics for the next time you get sick
Are Antibiotics Right For You
While you have many options for antibiotics to treat your sinusitis, your doctor will be the final say in what is prescribed. Your doctor will take into account all your healthcare considerations and prescribe a medicine that will fight infection and can be tolerated well. In many cases, the infection may be viral or secondary to a separate disorder. In some cases it can be caused by allergies which will require different courses of treatment. If you notice symptoms of sinusitis lasting more than ten days, talk to your doctor to see if an antibiotic is needed to manage your symptoms.
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What Decongestants And Nasal Sprays Soothe Or Cure Sinus Infections Or Sinusitis
Taking decongestants and mucolytics orally may be helpful in assisting drainage of sinus infection.
The treatment of chronic forms of sinus infection requires longer courses of medications, such as Augmentin, and may require a sinus drainage procedure. This drainage typically requires a surgical operation to open the blocked sinus under general anesthesia. In general, antihistamines should be avoided unless it is felt that the sinusitis sinus infection is due to allergies, such as from pollens, dander, or other environmental causes.
It is likely that the use of a topical nasal steroid spray will help reduce swelling in the allergic individual without the drying that is caused by using antihistamines although both are occasionally used. Oral steroids may be prescribed to reduce acute inflammation and to help with chronic inflammation in cases with or without polyps and in allergic fungal sinusitis.
In many people, allergic sinusitis develops first, and later, bacterial infection occurs. For these individuals, early treatment of allergic sinusitis may prevent the development of secondary bacterial sinusitis.
In rare instances or in natural disasters, fungal infections may develop in debilitated people. Death rates of 50%-85% have been reported for patients with these sinus infections. Treatment relies on early diagnosis followed by immediate surgical debridement, antifungal drugs, , and stabilizing any underlying health problem such as diabetes.
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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How Do You Get Rid Of A Sinus Infection
Sinusitis symptoms are notoriously unbearable. Finding relief from the congestion, sinus pain, and sore runny nose can be difficult and uncomfortable.
In many cases, people turn to natural remedies and/or over-the-counter treatments to help relieve their physical discomforts, such as headaches, congestion, and mucus build-up.
In more serious cases, its good to consult a physician to discuss prescription options, such as corticosteroids, antibiotics, or antifungal medicines. These medications are often delivered intranasally , with the use of a nasal nebulizer device.
Nasal washing or irrigation with saline or a common over the counter nasal safe medicine can help reduce the excess mucus build-up and relieve other symptoms of post nasal drip, such as hacking and coughing.
Using compounding pharmacies to compound a sinus medication specifically for your needs, incorporating soothing ingredients to eliminate dry nose, can be very effective, especially when delivered appropriately to the infected and irritated areas.
How Is Sinus Infection Diagnosed
Diagnosis depends on symptoms and requires an examination of the throat, nose and sinuses. Your allergist will look for:
- 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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What Are The Six Types Of Sinusitis And Sinus Infections
Sinusitis may be classified in several ways, based on its duration and the type of inflammation . The term rhinosinusitis is used to imply that both the nose and sinuses are involved and is becoming the preferred term over sinusitis.
- Acute sinus infection usually lasts less than 3-5 days.
- Subacute sinus infection lasts one to three months.
- Chronic sinus infection is greater than three months. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.
- Recurrent sinusitis has several sinusitis attacks every year.
There is no medical consensus on the above time periods.
- Infected sinusitis usually is caused by an uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of a sinus infection usually are the result of incomplete treatment of an acute sinus infection.
- Noninfectious sinusitis is caused by irritants and allergic conditions and follows the same general timeline for acute, subacute, and chronic as infectious sinusitis.
Can A Sinus Infection Last For Months
Sinusitis wont go away at the drop of a hat. It tends to linger and, if left untreated, it can last for months. Again, its best to take a trip to your doctors office if your symptoms last longer than one week.
Note that there is a chance that long-term sinus issues may be caused by allergens. If this is the case, then your sinus symptoms will likely last until you can escape the allergen or have the allergies treated.
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How To Treat Sinusitis
With symptoms that linger, it can be hard to treat and get rid of a sinus infection for good.
Antibiotics are the standard treatment for combating sinus infections. Taken anywhere from 3 to 28 days, antibiotics help fight the bacteria. Because antibiotics dont typically alleviate symptoms, nasal decongestants, antihistamines, topical nasal corticosteroids and nasal saline can help to manage them.
How You Can Treat Sinusitis Yourself
You can often treat mild sinusitis without seeing a GP by:
- getting plenty of rest
- taking painkillers, such as paracetamol or ibuprofen
- avoiding allergic triggers and not smoking
- cleaning your nose with a salt water solution to ease congestion
You do not need to use all of the solution, but make a fresh solution each time you clean your nose.
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Managing Side Effects Of Antibiotics
While there are some cases in which you may be prescribed antibiotics for a common cold, these medications aren’t harmless. There are many side effects of antibiotics. Some are common, and others can be severe and potentially deadly.
- Allergic reactions
- Vaginal itching or yeast infections
- Nausea and vomiting
In a dataset from 2013 and 2014, adverse drug reactions caused 4 out of every 1,000 emergency room visits each year. The most common reason for the visit among children was an adverse reaction to antibiotics.
If you or your child is experiencing side effects from a prescribed antibiotic, make sure to tell your healthcare provider to be certain its nothing to worry about. Theyll also let you know if you should continue taking it or stop.
If youre taking antibiotics, here are a few things you can do to help ward off some side effects of antibiotics:
- Take a probiotic and eat fermented foods like yogurt and kefir.
- Limit sun exposure.
- Take your antibiotic as prescribed .
- Make sure to store it correctly .
- Ensure your healthcare provider knows about all other drugs and supplements youre taking.
What Is A Sinus Infection Or Sinusitis
Inflammation of the air cavities within the passages of the nose is referred to as sinusitis. Sinusitis can be caused by infection , but also can be caused by allergy and chemical irritation of the sinuses. A sinus infection occurs when a virus, bacterium, or fungus grows within a sinus.
Sinusitis is one of the more common conditions that can afflict people throughout their lives. Sinusitis commonly occurs when environmental pollens irritate the nasal passages, such as with hay fever. Sinusitis can also result from irritants, such as chemicals or the use and/or abuse of over-the-counter nasal sprays, and illegal substances that may be snorted or inhaled through the nose. About 30 million adults have “sinusitis.” Colds differ from sinusitis and are only caused by viruses and last about seven to 10 days while sinusitis may have many different causes , and usually last longer with more pronounced and variable symptoms.
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Sinus Infection Treatment Timeline With Antibiotics
Our sinuses are hard to reach, so it can be two to three days before antibiotic treatment begins to take effect.
It is critical to continue the whole course of antibiotics, even if you start to feel better. If you dont finish the whole course, your body could begin to build a resistance to those antibiotics. This makes future treatment more difficult.
Sometimes, patients experience negative side effects while taking antibiotics. If you experience rash, hives or have difficulty breathing while taking antibiotics, call your doctor immediately. You may be experiencing an allergic reaction. In older adults, some types of antibiotics may cause inflammation in tendons.
In addition to clearing your sinuses of infection, antibiotics also work in other parts of your body, particularly the gut. This could cause diarrhea, so you may want to take a probiotic as well.
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.
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When To Contact A Medical Professional
- Your symptoms last longer than 10 to 14 days or you have a cold that gets worse after 7 days.
- You have a severe headache that is not relieved by over-the-counter pain medicine.
- You have a fever.
- You still have symptoms after taking all of your antibiotics properly.
- You have any changes in your vision during a sinus infection.
A green or yellow discharge does not mean that you definitely have a sinus infection or need antibiotics.
Do I Need Antibiotics For Every Sinus Infection
Many sinus infections are caused by viruses, the ones that cause the common cold. These types of infections are not cured by antibiotics. Taking an antibiotic for a viral infection unnecessarily puts you at risk for side effects related to the antibiotic. In addition, the overuse of antibiotics can lead to antibiotic resistance, which may make future infections more difficult to treat.
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What Are The Symptoms Of A Sinus Infection
If youve ever suffered from a sinus infection , you know that the symptoms, such as the constant dripping from your nose or the sore irritated throat, are just shy of unbearable. Heres a list of symptoms you might experience if youre suffering from sinusitis:
- Sinusitis is typically accompanied by a stuffy, congested nose.
- People typically report difficulty breathing through their nose, often with discolored discharges and/or a runny nose.
- Many people complain of post-nasal drip, which is the term for the mucus running down the back of your throat. This can lead to irritation because of the constant swallowing, coughing and clearing-of-the-throat.
- In some cases, people may experience anosmia due to the smell receptors being blocked and irritated. It typically resolves itself after the symptoms have cleared, although there are treatments to help speed up the recovery process.
- People also report a feeling of swelling, tenderness, and pain around the eyes and in the forehead.
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Do I Need Antibiotics For A Sinus Infection
Sinus infections can be extremely frustrating, especially when you have a headache and facial pain that doesnt go away, coupled with the inability to breathe through your nose. You want immediate relief, but unfortunately, it takes at least a few days to start feeling better. You may think you need to go to the doctor and get antibiotics for a sinus infection, but this isnt always the case.
In the winter months, sinus infections, colds, bronchitis, pneumonia, the flu, and other respiratory infections are common. Patients think that if they come down with an illness, they will require antibiotics. However, most sinus infections dont require antibiotics.
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When Antibiotics Are Appropriate
There are only a few situations in which your healthcare provider might prescribe antibiotics when youre dealing with a cold or flu. Usually, these are secondary bacterial infections caused by the cold or flu symptoms that cause issues in the sinuses or other structures of the upper respiratory system.
Antibiotics may be helpful if common cold symptoms last for more than 10 days, the Cochrane report found.
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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