Which Antibiotics Are Best For Sinus Infections In Children
- The antibiotic of choice for both children and adults who are not allergic to penicillin is amoxicillin with clavulanic acid .
- Azithromycin is NOT recommended for sinusitis due to bacterial resistance.
- Cefinir and other cephalosporins are NOT recommended for sinusitis except in combination therapy with clindamycin for children with non-life- threatening allergic reactions to penicillin. In these cases, the cephalosporin of choice is cefixime .
- Levofloxacin or doxycycline are the recommended antibiotics for adults with true penicillin allergies. Levofloxacin can also be considered for the treatment of children with life-threatening allergic reactions to penicillin. Doxycyline is not for use in children.
- Oral decongestants are not recommended for the treatment of sinusitis. Antihistamines may be used if there are underlying seasonal/environmental allergies.
- Nasal steroid sprays and nasal saline flushes can be helpful for sinusitis.
Lou Romig, MD, FAAP, FACEP, Medical Director
After Hours Pediatrics Urgent Care
How Long Do Symptoms Last
Typically, a sinus infection clears up within 2 to 3 weeks. COVID-19 lasts for about a week or two depending on its severity and your overall health.
A 2020 study surveyed 270 outpatients with COVID-19. Among them, 175 people reported returning to their usual level of health about 7 days after a positive COVID-19 test.
Some symptoms like cough and loss of smell or taste may linger temporarily after COVID-19. Some people may experience long-haul COVID-19, a group of symptoms that persist in the weeks and months following an infection.
Types Of Sinus Infection
A sinus infection can appear in four different ways. Each way is based on the timeframe of the infection and how persistent it is. The four types of sinus infection are:
- Acute sinusitis comes on suddenly and lasts less than four weeks.
- Subacute sinusitis comes on like acute sinusitis but resolves within 12 weeks.
- Chronic sinusitis happens when your symptoms persist longer than 12 weeks.
- Recurrent acute sinusitis is when you have four or more acute sinus infections lasting seven days each, in a one-year span.
If your sinus infection lasts for long periods of time without any relief, even with the use of over-the-counter medicine, you should schedule an appointment with your doctor.
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Are Sinus Infections Contagious
Only viral sinus infections are contagious. Suppose you developed your sinus infection by contracting a virus like the common cold. In that case, your sinus infection is contagious. You should wear a mask and socially distance yourself from others to avoid spreading it, much like COVID-19.
Bacterial sinus infections can be caused by pollen in the air. These arent infectious, and you wouldnt need to take the same precautions as with a sinus infection resulting from a virus.
For more information on the treatment of sinus infections, visit an online doctor. Not only are virtual doctors visits often more affordable than in-person visits, but theyre also totally contact-free. Book an appointment with our partner PlushCare here and speak with one of the countrys best doctors today.
Best Ways To Treat A Cold
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How Can Sinus Infections Or Sinusitis Be Prevented
Prevention of a sinus infection depends upon its cause.
- Avoid contracting upper respiratory tract infections. Maintain strict hand washing habits and avoid people who are suffering from a cold or the flu.
- Obtaining the flu vaccination yearly will help to prevent the flu and subsequent infection of the upper respiratory tract.
- In some studies, zinc carbonate lozenges have been shown to reduce the duration of many cold symptoms.
- Stress reduction and a diet rich in antioxidants, especially fresh, dark-colored fruits and vegetables, may help strengthen the immune system.
- Plan for seasonal allergy attacks.
- If a sinus infection is caused by seasonal or environmental allergies, avoiding allergens is very important. If avoidance is not an option, either OTC or prescription medication may be helpful. OTC antihistamines or decongestant nasal sprays can be used for an acute attack.
- People who have seasonal allergies may benefit from nonsedating prescription antihistamines during allergy-season.
- Avoid spending long periods outdoors during allergy season. Close the windows to the house and use air conditioning to filter out allergens when possible. Humidifiers may also be helpful.
- Allergy shots, also called “immunotherapy,” may be effective in reducing or eliminating sinusitis due to allergies. An allergist administers shots regularly for 3 to 5 years, which often produces a reduction or complete remission of allergy symptoms for years.
Typical Symptoms Of A Bacterial Sinus Infection
- Similar symptoms to a viral sinus infection
- Fever that lasts several days in a row
- Symptoms become worse after 7-10 days
- Often requires antibiotics
With so many similar symptoms, how do you know whether your fever is indicative of a viral or bacterial sinus infection though? The key is really in how long the fever lasts. If your fever only lasts about a day, then its likely viral. If your fever lasts for several days, then its likely bacterial.
As far as treatment goes, over the counter medications tend to manage symptoms well for viral sinus infections. If its bacterial though, then youre likely going to need antibiotics. In either case, its best to see your doctor though. Untreated sinus infections can have long term negative impacts on your health, and your doctor will be able to determine which treatments will work best for you.
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Signs And Symptoms Of Sinus Infection
An uncomfortable full or feeling of pressure in your face is an easily identifiable symptom of sinus infection. Sinus infection may be the result of a cold that has become infected or may be caused by another underlying medical condition. Some common symptoms to look for to know if you have a sinus infection are:
Stuffy nose and face
One of the first signs of sinus infection is tenderness of your face. Youll feel most of the pain under your eyes or at the bridge of your nose. This happens because your sinus cavities are full of mucus that isnt draining properly. You may also experience nasal stuffiness or congestion. Pain in the teeth and frontal headaches are also common symptoms.
A post nasal drip is a common symptom of sinus infection. It can lead to sore throat because your excess mucus is full in your sinus cavity and draining down your throat. This irritates the back of your throat, causing it to feel sore and painful.
A persistent cough can be a sign of sinus infection. Your cough may be wet and feel mucusy. This is your bodys way of trying to clear your throat from mucus drainage.
A low-grade fever is another common symptom of sinus infection. It happens because your body is fighting an infection in your sinuses. If your fever lasts longer than four days and becomes very high, seek immediate medical attention.
Symptoms Of An Ear Infection
The primary symptoms of an ear infection include acute ear pain and hearing loss. You will have the sensation that your hearing is muffled and you may experience referred pain to your throat or fluid in the middle ear.
When youre experiencing an ear infection, you may not necessarily see a change in color in or outside your ears.
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How Long Do Sinus Infections Or Sinusitis Last
Sinusitis or sinus infections usually clear up if treated early and appropriately. Aside from those who develop complications, the outlook for acute sinusitis is good. People may develop chronic sinusitis or have recurrent attacks of acute sinusitis if they have allergic or structural causes for their sinusitis.
When A Sinus Infection Wont Go Away
While its true that sinus infections sometimes clear on their own, antibiotics can sometimes shorten their duration.
Talk with your doctor if your symptoms dont subside within 10 days or if you have persistent fevers, facial swelling or neck stiffness. As with colds, make sure you hit the sheets and get enough rest and drink your H2O. Proper hydration and nasal irrigation can ease sinus infection symptoms.
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Do I Have Covid Or A Sinus Infection
Although some of the symptoms are shared, there are several distinct ways to tell if you have covid or a sinus infection.
Its human nature to sometimes think the worst if you experience any symptoms in todays environment but in fact, the common cold, influenza, allergies, and sinus infections share some of the same symptoms as the COVID-19.
Heres how you can tell the difference and when you should consider seeking medical help.
Diagnosing A Sinus Infection
To diagnose a sinus infection, your doctor will feel for tenderness in your nose and face. They will also look inside your nose and can usually make a diagnosis based on a physical exam. To visually inspect your sinuses, the doctor may use a nasal endoscopy, where they insert a thin, flexible tube into your nostril.
For more severe cases, your doctor may recommend imaging studies like a CT scan. These are less common and typically only used when the doctor suspects complications or abnormalities. If you have chronic sinus infections, your doctor may want to examine your sinuses for deformities or damage.
To diagnose a sinus infection, your doctor will feel for tenderness in your nose and face. They will also look inside your nose and can usually make a diagnosis based on a physical exam.
If the treatment for your sinus infection doesnt seem to be working or if the infection comes back, the doctor may take tissue samples from your nose and sinus cavities. While lab tests arent generally necessary for an initial diagnosis, these cultures may help a doctor check for indications of a more severe bacterial infection.
If your persistent sinus infections arent caused by damage or deformity to the sinuses themselves, you may be referred to an allergist for allergy testing to help pinpoint the allergens responsible and help you avoid them or take medications to control the reactions.
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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.
Some Steps You Can Take
Whether your sinus infection turns out to be viral or bacterial, you can help to ease your symptoms early on with supportive sinus care:
If your symptoms arent improving after one week, its important to see your doctor. If a bacterial infection is suspected, youll probably need to take an antibiotic to clear up the infection and prevent further complications.
If your infections occur more frequently, and your doctor really wants to establish if they are bacterial or viral, your Otolaryngologist or ear, nose and throat doctor can sample the snot from your nose when youre infected and send it to a laboratory to know for sure.
Note: Antibiotics wont help a viral infection, and taking an antibiotic unnecessarily can do more harm than good. You risk possible side effects and increase your chances of developing antibiotic resistance, which can make future infections harder to treat, says Dr. Sindwani. So its important to wait and see how long your symptoms last.
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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.
Sore Throat And Hoarse Voice
Postnasal drip can leave you with a raw and aching throat. Although it may start as an annoying tickle, it can get worse.
If your infection lasts for a few weeks or more, mucus can irritate and inflame your throat as it drips, resulting in a painful sore throat and hoarse voice. Frequent coughing and throat clearing can make a hoarse voice worse.
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What Causes A Sinus Infection
Before you can begin finding relief from the symptoms of a sinus infection, its important to understand whats causing it.
One of the most common causes of sinusitis is a virtual infection, such as the common cold or influenza. As a result, most people have experienced at least a mild sinus infection at some point.
Its not common for a viral infection to develop into a secondary bacterial infection but it does happen occasionally. And, in some cases, fungal infections may be the source of the sinusitis symptoms.
People who suffer from allergies , nasal polyps, a deviated septum, or dental infections are also more likely to experience a sinus infection. In many cases, these sufferers will develop chronic sinusitis, requiring treatment management strategies.
Best Ways To Treat A Sinus Infection
If you think you may have a sinus infection, see your doctor right away because you most likely need antibiotics, and the sooner you start, the sooner youll feel better.
Sinus irrigation is also recommended for sinus infections as well for colds. It can help ease your symptoms while you wait for the antibiotics to start working. Steroids, decongestants and over-the-counter mucus thinners can also ease your discomfort.
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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.
Which Medications Open The Sinuses Will Antibiotics Cure Sinus Infections
Medications that Cure Sinus Infections
The goal in treating sinus infections is to eliminate bacteria from the sinus cavities with antibiotics. This helps prevent complications, relieve symptoms, and reduce the risk of chronic sinusitis.
- In acute, uncomplicated sinus infections, a synthetic penicillin, for example, amoxicillin , which is prescribed to most people to cure acute sinus infections. Amoxicilin is effective against the ususal causes of sinus infections, and is inexpensive. The most common side effects of amoxicillin include allergic reactions and an upset stomach.
- People allergic to penicillin can take a sulfur-containing antibiotic called trimethoprim/sulfamethoxazole or TMP/SMX . Sulfa drugs are not recommended for people who are allergic to sulfur.
- People who have several episodes, or partially treated acute sinusitis or those who have chronic sinusitis may become resistant to amoxicillin and TMP/SMX. Synthetic penicillins and cephalosporins such as amoxicillin/clavulanate , cefuroxime , and loracarbef can cure most sinus infections.
- Eventually, overuse of these “broad-spectrum” antibiotics may lead to organisms evolving that can resist even the most potent antibiotics available. Simpler antibiotics, for example, amoxicillin, should be used first and taken for the entire duration .
Medications to Keep the Sinuses Open
OTC Steroid Nasal Sprays
Steroids are potent inhibitors of inflammation.
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