Sunday, December 4, 2022

Do Doctors Prescribe Antibiotics For Sinus Infections

What Are The Possible Treatments For A Sinus Infection

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

In most cases, you probably wont need to see a doctor to treat your sinus infection. Sinus infections typically clear up on their own, although there are times when you may need a doctors help to recover.

At-home remedies that relieve symptoms include:

  • Taking over-the-counter pain relievers like aspirin and ibuprofen
  • Rinsing your nasal cavities with a neti pot or saline nasal spray
  • Taking over-the-counter decongestants to improve the flow of mucus
  • Using a nasal spray like Flonase that will reduce nasal inflammation

If your symptoms last longer than 10 days, then you should probably see a doctor to get prescription medications that will help you recover from your sinus infection. Your doctor may prescribe decongestants that you cant get over the counter.

Most doctors try to avoid using antibiotics to treat sinus infections. Since the majority of sinus infections clear up without antibiotics, it makes sense for doctors to avoid the prescription. If your sinus infection lasts an unusually long time, though, your doctor may give you antibiotics. Make sure you take all of the prescribed pills to prevent your symptoms from returning.

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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 âNeti-Potâ 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.

Viral Vs Bacterial Sinus Infections

Most sinus infections are caused by viruses that create inflammation in the sinuses, leading to blockage that can make it hard to breathe, nasal secretions, postnasal drip, and other discomfort like facial pain around your eyes, cheeks, nose, or forehead.

Knowing thisand that antibiotics dont work on viral infectionsmost healthcare providers first recommend treatments to relieve the symptoms of a sinus infection while you wait for it to resolve.

These may include:

  • Over-the-counter such as pseudoephedrine
  • Pain relievers like acetaminophen or ibuprofen to ease discomfort from swelling, fever, or sore throat

In rare cases, viral sinus infections can lead to bacterial growth in the nasal passages.

Theres no way to know for sure if you have a bacterial sinus infection without testing a mucus sample.

But even without a sample, two signs typically indicate a bacterial infection and may prompt your provider to prescribe antibiotics:

  • A sinus infection that lasts for more than 10 days
  • Symptoms of the infection resolve, then back worse a couple days later

Some people think yellow or green mucus may be a sign of a bacterial sinus infection, but colored mucus can occur with viral infections and does not necessarily mean you have a bacterial infection.

If you do have bacterial sinusitis , it should respond to antibiotics within a few days.

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When To See A Doctor For Asinus Infection

Acute sinusitis often goes away on its own however, there are times when you should see your doctor for sinus infection treatment if self-care doesnt work. You should see a doctor if you still have sinusitis symptoms after a week or if they return more than a few times within a year. You should also see a doctor as soon as possible if the infection worsens. Signs of a worsening sinus infection include:

Things To Know About A Sinus Infection

Sinus Infection (Sinusitis)
  • 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
  • cloudy discolored nasal or postnasal drainage,
  • the feeling of nasal stuffiness,
  • pus-like nasal discharge, and
  • symptoms that persist for longer than a week and that are not responding to over-the-counter nasal medications.
  • Sinus infection is generally diagnosed based on the patient’s history and physical examination.
  • Bacterial sinusitis is usually treated with antibiotics. Early treatment of allergic sinusitis may prevent secondary bacterial sinus infections.
  • Home remedies for sinusitis and sinus infections include over-the-counter medications such as acetaminophen , decongestants, and mucolytics. Nasal irrigation can be accomplished with a Neti-pot or rinse kit .
  • Rare fungal infections of the sinuses are medical emergencies.
  • Complications of a sinus infection that may develop are meningitis, brain abscess, osteomyelitis, and orbital cellulitis.
  • Recommended Reading: How To Relieve Sinus Headache

    Caveats: Refer Seriously Ill Patients And Complicated Cases

    A very important caveat to our recommendation is that seriously ill patients must be managed differently. Very infrequently a patient develops a serious complication of acute sinusitis such as brain abscess, periorbital cellulitis, or meningitis. Therefore, seriously ill patients with signs and symptoms of acute bacterial sinusitis, such as high fever, periorbital erythema or edema, severe headache, or intense facial pain must be carefully evaluated and treated with great caution and close follow-up. These patients should be referred immediately for consultation with an otolaryngologist.

    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-analysis3 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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    Most Sinus Infections Dont Require Antibiotics

    Ah, sinus infections. 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.

    Got A Sinus Infection Antibiotics Probably Wont Help

    Are antibiotics needed for a sinus infection?

    Go ahead and blow, but resist the antibiotics for a typical sinus infection.hide caption

    toggle caption

    Go ahead and blow, but resist the antibiotics for a typical sinus infection.

    If youve ever had a painful sinus infection, all you want is relief fast!

    So off to the doctor you go, and, as often as not, you get a prescription for an antibiotic.

    Three days later, you start to feel a little better. Thank goodness for amoxicillin! you might say. Well, probably not quite like that, unless youre a nerdy health blogger, but youd be saying something nice about getting a prescription from your doctor.

    Well, it turns out you might have been just as happy getting nothing but advice to take a little acetaminophen for the pain, some over-the-counter cough medicine, a decongestant and regular spritzes of saline up your nose.

    Researchers at Washington Universitys med school worked with a bunch of primary care doctors around St. Louis to test whether an antibiotic was any better than a placebo for the treatment of run-of-the-mill sinus infections. Half the patients got amoxicillin and the rest got a sugar pill.

    Almost all the 166 people got offered the other remedies to relieve symptoms, and most took advantage of a least some of them. That was true whether they got the antibiotic or not.

    What was surprising was, at Day Three there was no difference, he says. For patients with bacterial infections, the researchers thought an antibiotic might speed up relief.

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    Side Effects Of Using Amoxicillin For Sinusitis

    Every drug comes with its own set of side effects. And, this antibiotic also has. Some of the most common side effects of using this drug are:

    • Metallic taste in the mouth

    Prolonged use of this medication could cause dark urine, abdominal pain, and skin rashes/hives. If you experience any such condition, please visit the doctor.

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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.

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    What Is The Best Medicine For Sinusitis

    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.

    Do Antibiotics Treat Sinus Infections

    For Sinus Infection, Donât Bother with Antibiotics. Try this instead ...

    Antibiotics are a type of medication that stops bacteria from growing and, as a result, improves symptoms of an infection.

    Healthcare providers only prescribe antibiotics for sinus infections that they believe are bacterial.

    Antibiotics dont work on viral or fungal infections, and taking antibiotics when you dont need them can cause unnecessary side effects such as diarrhea, nausea, and stomach pain.

    Plus, taking antibiotics too often can create antibiotic resistance.

    The most common antibiotics prescribed for sinus infections are penicillin-class antibiotics such as amoxicillin or amoxicillin-clavulanate .

    If you have a penicillin allergy, a common alternative is doxycycline.

    Recommended Reading: What Are Some Symptoms Of Sinus Problems

    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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    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

    Recommended Reading: What Is Good To Take For Sinus Pressure

    How Is Sinusitis Diagnosed

    If you are experiencing pain and pressure that doesnât clear up within a week to 10 days, it may be time to schedule a doctors appointment. You can visit your primary care physician to be evaluated for a sinus infection.

    A sinus infection is usually diagnosed empirically without need for imaging or cultures, explains Lindsey Elmore, Pharm.D., BCPS. A simple medical exam and review of your symptoms should be enough for your doctor to identify a sinus infection. Your doctor will likely check your nose with a light to look for inflammation. He or she also may ask you about any pain youre feeling to see if it traces back to the sinus cavities.

    In rare cases, or if you get frequent infections, your doctor may perform other tests to rule out other conditions like a fungal infection. This may include allergy testing, a nasal endoscopy to visually inspect the sinuses, swabbing your nose for a culture of nasal drainage, or lab imagery to scan for abnormalities.

    Symptoms may be acute or chronic , and you should seek a doctors help if you have symptoms that last more than 10 days, or are unresolved with over the counter agents as this may be an indication that you have a bacterial sinus infection, says Dr. Elmore.

    Symptoms > 1 Week Are Not A Reason To Prescribe

    Wellness Wednesday: Antibiotics for sinus infections?

    One very important new finding in this meta-analysis that should change practice is that the duration of illness did not predict a positive response to antibiotics.

    Current national recommendations are to use an antibiotic for patients with a duration of illness longer than 1 week, as these patients are presumably more likely to have a bacterial infection.57 However, that recommendation had been based on expert opinion, not on data from clinical trials. A longer duration of symptoms should not be a reason to prescribe an antibiotic for sinusitis symptoms.

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    Study: Antibiotics Overprescribed For Sinus Infections

    Donald Leopold, M.D., demonstrates the use of a saline nasal rinse that he says in many cases should be used over antibiotics to treat sinus infections. Dr. Leopold, professor and chairman of the UNMC Department of Otolaryngology-Head and Neck Surgery, contributed to a study that showed U.S. physicians may be overprescribing antibiotics for sinus infections.

    The study shows U.S. physicians prescribe antibiotics for nearly 83 percent of acute sinus infections and roughly 70 percent of chronic sinus infections, despite viruses, not bacteria, being the most frequent cause of these conditions. Viruses are not affected by antibiotics. The impact of the study is large because an estimated 20 percent of adults and 10 percent of children currently on antibiotics take them for sinus infections.

    Hadley Sharp, lead author of the paper, and colleagues in the UNMC Department of Otolaryngology-Head and Neck Surgery, used data from two national surveys to assess the medications prescribed for sinus infections at physicians offices and hospital outpatient and emergency departments between 1999 and 2002. The surveys were conducted by the National Center for Health Statistics and designed to be representative of the U.S. population.

    Rhinosinusitis, commonly referred to as a sinus infection, is an inflammation of the sinus cavities that are adjacent to the nasal passages.

    Home Remedies And Lifestyle

    At-home remedies can greatly reduce sinus infection symptoms, although they do not treat the infection.

    Saltwater nasal irrigation is one of the treatments of choice for the symptoms of chronic sinusitis in adults, though studies show no benefit for children.Nasal irrigation is easy to do at home using a neti pot or other sinus rinse methods.

    Using a steam vaporizer or a warm or cool mist humidifier may help keep your mucus thin. Inhalation of steam mixed with eucalyptus, chamomile, or peppermint may also help. While thereâs no scientific research that these additives improve symptoms, you may find them soothing.

    Hot vaporizers are a burn hazard and should not be used near your face or around children.

    Other helpful tips:

    • A hot shower may relieve pain, promote drainage, and open up the sinus cavities.
    • Reduce facial pain and swelling by applying a warm compress to your face.
    • Drink lots of fluids and get plenty of rest.

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    Why Do I Need Antibiotics For Sinus Infection

    You should use antibiotics for a sinus infection when it is clear that its been caused by bacteria.

    Its probably a bacterial infection if you notice the following:

    • Symptoms persist for seven days or more, especially if they seem to get better and then worsen.
    • Your mucus is yellow or green and thick.
    • Your facial or sinus tenderness is severe, mainly if one side of your face is worse.
    • Pain in your upper teeth area is worse on one side.

    Contact your physician if the infection becomes severe, comes back, or isnt getting better on its own.

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