What Causes Chronic Sinus Infection
Multiple factors acting together usually contribute to chronic sinusitis.
People with allergies are more prone to develop chronic sinusitis. About one in five people with chronic sinusitis also have asthma. This is because the linings of your nose and sinuses are in continuation with the linings of your lungs. These people are also likely to have nasal polyps .
A bacterial or viral infection can also trigger the condition. The infection is often low grade. The bacteria confine themselves in stubborn biofilms, making it difficult for your immune system or antibiotics to find and attack them.
An overlap of additional factors such as smoking, environmental pollutants, and deviated septum, further complicate the picture of chronic sinusitis.
It would be more appropriate to say that if youre already prone to allergies and nasal polyps, it becomes easier for harmful bugs, especially fungi to penetrate your sinuses. Likewise, a weak immune system makes you more susceptible to catch bacterial, viral, or fungal sinus infection.
A sinus that is inflamed and swollen can no longer sweep away the excess mucus and harmful agents due to the blockage of tiny hairs that facilitate this function.
Can Sinusitis Cause Death
Chronic sinusitis can spread to the eyes, blood, and brain, and, in rare circumstances, cause death. For that reason, its important to take instances of sinusitis that wont go away very seriously. If you have a persistent sinus infection, make sure you follow your doctors instructions regarding your antibiotics and of course, get plenty of rest.
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When Antibiotics Dont Work
Some patients suffer from recurring sinus infections. If your sinus infection does not improve within five to seven days after you finish the whole course of antibiotics, or if you experience another sinus infection within a few weeks, you may be referred to an Ear, Nose and Throat specialist for treatment.
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Will My Sinus Infection Clear Up On Its Own
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The first few weeks of the common cold aren’ fun, but the acute sinusitis that can develop afterwards doesn’t help either. Unfortunately, sinus congestion and the common cold 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.
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Sinus infections can be very bothersome. The runny, stuffy nose. The congestion. The headache pain. Sinus infections typically have two causes: bacteria and viruses.
1. Bacterial Sinus Infections
Bacterial sinus infections are rare. Less than 2% of sinus infections are caused by bacteria. Thatâs 1 in 50 sinus infections. This fact is important because antibiotic medications are only helpful for these rare cases of bacterial sinus infection. Signs of a bacterial sinus infection are:
- Severe symptoms, such as severe headache or facial pain.
- Symptoms that get worse after initially improving.
- Symptoms lasting more than 10 days without improvement.
- Fever longer than 3-4 days.
This list is according to the Centers for Disease Control and is not all inclusive.
2. Viral Sinus Infections
Viruses are the most common cause of sinus infections. Antibiotics will not help to treat viral sinus infections. The bodyâs immune system will kill the virus on its own. However, there are medications and treatments that can help relieve the symptoms of viral sinus infections.
Sinus infections are not fun. They can last a week or more. You will get better, it just takes time and some of the above strategies. Not sure where to start? First Stop Health doctors are available in minutes and can help advise you on the best treatment plan.
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What Is The Treatment For Chronic Sinus Infection
When it comes to treating chronic sinusitis, theres no one-size-fits-all solution. While several treatment options are available, what works for one person may not be appropriate for the other. Hence, we tailor the treatment to each individuals needs, symptoms, and whether or not other conditions are also at play.
The goals of treating chronic sinusitis are to address the allergic causes, minimize inflammation, promote free sinus drainage, and eradicate the infection .
Here are a few potential treatment options for chronic sinusitis. We will likely try out a combination of two or more of these options to see what works best for you.
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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Surgical Treatment For Chronic Sinusitis
Although medical therapy and lifestyle tweaks are the first-line treatment for chronic rhinosinusitis, some people may fail to respond to optimal therapy. In such cases, Ear, Nose Throat and Allergy Specialist performs a surgery to widen up the blocked sinuses and remove any trapped mucus or polyps.
Other situations in which surgery could be considered include:
- When chronic sinusitis symptoms do not respond to the medical treatments listed above, and CT scan of your sinuses reveals complete blockage of one or more sinuses.
- When nasal polyps fail to shrink enough with steroids.
- When a severe deviation of the septum completely blocks your nose or hinders sinus drainage.
- When theres a suspicion of allergic fungal sinusitis. The sinuses in allergic fungal sinusitis get clogged with thick, dense mucus that is hard to remove in any way other than surgery.
How To Cope With Side Effects
What to do about:
- weight gain try to eat wellwithout increasing your portion sizes so you dont gain too much weight. Regular exercise will also help to keep your weight stable.
- indigestion take prednisolone with food to reduce the chances of stomach problems. It may also help if you avoid rich or spicy food while youre taking this medicine. If symptoms carry on, ask your doctor if you may benefit from taking an additional medicine to protect your stomach.
- sleep problems take prednisolone in the morning so the levels are the lowest at bedtime
- restlessness if youre restless when youre trying to sleep, take prednisolone in the morning so the levels are the lowest at bedtime
- sweating a lot try wearing loose clothing, use a strong anti-perspirant and keep cool with a fan. If this doesnt help, talk to your doctor as you may be able to try a different medicine.
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For decades, weve specialized in helping adults and children with a variety of illnesses, whether that means assisting them through the inconvenience of allergy season or providing facial plastic surgery.
Our physicians are nationally recognized experts who are dedicated to providing the timely, effective and compassionate care you deserve.
Scheduling an appointment is easy. Contact us today. We would consider it a privilege to care for you.
Which Types Of Doctors Treat Sinusitis And Sinus Infections
- Many sinus infections can be treated by your primary care physician or an Internal Medicine doctor.
- However, it is not unusual to consult an ENT specialist, infectious disease specialist, or an allergist or immunologist.
- With some complex sinus infections, a surgeon who specializes in sinus surgery may be necessary to consult.
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When To Seek Medical Care
See a doctor if you have:
- Severe symptoms, such as severe headache or facial pain.
- Symptoms that get worse after improving.
- Symptoms lasting more than 10 days without getting better.
- Fever longer than 3-4 days.
You should also seek medical care if you have had multiple sinus infections in the past year.
This list is not all-inclusive. Please see a doctor for any symptom that is severe or concerning.
Other conditions can cause symptoms similar to a sinus infection, including:
- Seasonal allergies
Treatment For Sinus Infection
Whether you have an acute sinus infection or a chronic infection, a number of treatment options can relieve your discomfort. If youre in the early stage of an acute sinus infection, it may be appropriate to start at-home treatments while you monitor your symptoms. If your sinusitis worsens, youll need to call your doctor for medication and further care. Even if youre receiving treatment from your doctor, at-home care can help ease your symptoms.
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Sinus Infection Antibiotics No Help
Antibiotics, Steroid Spray No Help for Adult Sinus Infections
Dec. 4, 2007 — Neither antibiotics nor steroid sprays offer much help to adults with sinus infections, a British study shows.
One of the most common complications of the common cold or flu is a sinus infection. The symptoms: a stuffy nose a thick, dark-colored nasal discharge and head pain.
You’ve very likely had such an infection. And if, like 25 million other Americans, you went to a U.S. doctor, there’s a 90% chance you got a prescription for antibiotics.
You very likely had some side effects from that antibiotic. But it’s extremely unlikely the antibiotics you took were much help, according to a study by Ian G. Williamson, MD, senior lecturer at the University of Southampton, England.
“We are confident that if there is an effect of antibiotics on acute sinus infections, it is not very big — certainly not as big as people have been led to believe,” Williamson tells WebMD.
Williamson and colleagues studied 240 patients ages 16 and older whose symptoms suggested that they had a sinus infection caused by bacteria. Viruses also cause sinus infections, but antibiotics do not help viral infections.
Study patients received antibiotic treatment with amoxicillin, an antibiotic often used for bacterial sinus infections, with or without nasal steroid sprays. A fourth of the patients received no treatment at all, but just got inactive placebo pills and placebo sprays.
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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.
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Treating Sinus Infections Without Antibiotics
Tomah, WI – People often want antibiotics to tackle a sinus infection but that might not be the best treatment since most infections are caused by viruses. Antibiotics fight bacteria, not viruses.
There are also complications that can develop with dependency on these drugs. The more antibiotics are used the less effective they can become, with possible side effects like dizziness, stomach problems and rashes.
Instead of turning to antibiotics, Alan Conway, M.D., family physician at Mayo Clinic Health System Franciscan Healthcare in Tomah, suggests some alternative methods of treatment. Dr. Conway says, First of all, you should give yourself enough rest. Your body needs the time to fight the infection with full force, especially in the first few days when symptoms are the most severe.
Dr. Conway also says. Watch out for over-the-counter products that contain oxymetazoline. These products may relieve symptoms for a few days, but they can cause congestion if used longer than three days. Instead, use generic pseudoephedrine pills if you are stuffed up for more than three days.
Sinus infections can turn into a bacterial infection, due to the prolonged blockage in the sinus cavity. It is not easy to determine whether the infection is viral or bacterial, considering that the symptoms are the same for both. Even if the infection becomes bacterial, 70% of the time the infection will go away within two weeks without antibiotics.
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How Can I Prevent Sinusitis
Experts dont know a lot about how to prevent sinusitis. But the following tips may help:
- Avoid contact with allergens or irritants that trigger your nasal allergies.
- Keep your nose as free and clear as possible by taking your allergy medicines including topical nasal steroid sprays and using a nasal saline rinse.
- Avoid infections by washing your hands often during common cold season. Also avoid touching your face.
- Talk with your doctor about lifestyle changes that may help you prevent repeated sinus infections. These may include changes to your diet, maintaining good hydration, performing regular exercise, and reducing stress.
Medical Review: April 2021 by Sarah Goff, MD, PhD, and August 2022 by John James, MD
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Common Antibiotics For Sinus Infections
Antibiotics may be prescribed when symptoms of a sinus infection warrant such treatment. Common antibiotics for sinus infection include:
- Levaquin : Although this drug is sometimes prescribed as a first line of therapy for sinusitis, it has serious side effects and should only be used as a last resort.
Should You Visit A Specialist
If your sinus infection just wont go away or keeps coming back, it may be time to see an ear, nose, and throat specialist. An ENT treats conditions of the ear, nose, throat, head, face, and neck. It may be time to see an ENT if:
- Youve completed several courses of antibiotics without success
- Your doctor suspects nasal polyps or another blockage of the nasal cavity
- You have chronic sinusitis that lasts longer than 12 weeks
Living with a sinus infection is miserable and living with a sinus infection for weeks on end is worse. Contact your doctor or an ENT to get the treatment you need.
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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.
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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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.