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.
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Treatment For Sinusitis From A Gp
If you have sinusitis, a GP may be able to recommend other medicines to help with your symptoms, such as:
- steroid nasal sprays or drops â to reduce the swelling in your sinuses
- antihistamines â if an allergy is causing your symptoms
- antibiotics â if a bacterial infection is causing your symptoms and you’re very unwell or at risk of complications
You might need to take steroid nasal sprays or drops for a few months. They sometimes cause irritation, sore throats or nosebleeds.
A GP may refer you to an ear, nose and throat specialist if, for example, you:
- still have sinusitis after 3 months of treatment
- keep getting sinusitis
- only have symptoms on 1 side of your face
They may also recommend surgery in some cases.
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When To Consider Antibiotics For Sinus Infections
AAAAI advises that antibiotics for sinus infections should be considered only if you develop a fever of 102° F or higher, you have severe face pain and tenderness, your symptoms last longer than a week or so, or your symptoms improve and then worsen again.
Some patients with acute sinusitis do need antibiotics, and if they continue with a worsening infection without treatment, they can suffer dramatic complications such as loss of vision, meningitis, or brain abscess, Patel says.
If your doctor says you need an antibiotic, ask for generic amoxicillin/clavulanate, according to guidelines from UpToDate, which provides evidence-based treatment information to healthcare providers. Its usually the best choice and works as well as more expensive brand-name antibiotics.
Avoid taking fluoroquinolones, a group of antibiotics that includes ciprofloxacin and levofloxacin . Although widely used, the antibiotics are inappropriate for treating sinus infections and they pose serious risks.
In 2016, after a safety review, the Food and Drug Administration linked fluoroquinolones to disabling and potentially permanent side effects. The agency advised against using the drugs to treat common illnessesbronchitis, sinus infections, and urinary tract infections.
Can You Put Vicks In Your Nose
Its not safe to use Vicks VapoRub inside your nose as it can be absorbed into your body through the mucus membranes lining your nostrils. VVR contains camphor, which can have toxic effects if absorbed into your body. It can be especially dangerous for children if its used inside their nasal passages.
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When Antibiotics Are Appropriate Treatment
In addition, antibiotics can be given to those whose symptoms have gotten worse or those who show no improvement after seven days.
If antibiotics are given, a 10- to 14-day course is recommended, according to the practice guidelines. Amoxicillin or amoxicillin clavulanate are typically the first choice for people who are not allergic to penicillin.
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:
- 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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Halo Oral Antiseptic Berry
Halo is an oral antiseptic that protects against airborne germs. Protection from sickness is just a squirt away! It is packaged in a small 1 fl. oz. bottle and three sprays in the mouth kills 99.9% of many common harmful germs and bacteria that normally lasts for up to six hours. This is a great and a hassle-free tool for using while at school, bus, grocery store or in any crowded place there is.
Unlike the other oral antiseptics, this one has a kids formula and comes in two different varieties: citrus and berry flavor for adult and grape flavor for children. This is a kid friendly suggestion to suppress the common colds and prevent from further sinus complications including fever, congested and stuffy nose, sore throat and cough, and most especially flu.
Treating Sinus Infections Without Antibiotics
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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When Did You First Start Experiencing Sinus Issues Why Did You Decide To Try Virtuwellcom
I had been experiencing pain, congestion and other issues with my sinuses for well over a week. I had considered going to clinic, but the idea of dragging all of the boys along with me sounded horrible. I remembered my husband used virtuwell.com for his sinus infection last year and within a few days he was feeling better.
While making dinner, I logged onto virtuwell.com. It took me about 10 minutes to answer the questions about my condition and medical historywith at least 5 interruptions from the boys. I got my treatment plan soon after, which told me I had a bacterial sinus infection and a prescription was being sent to our Pharmacy in about an hour.
How Long Do Sinus Infections Last
Many variables affect the duration of sinus infections. Most last more than 10 days, but when a sinus infection lasts more than twelve weeks, it is considered chronic sinusitis.
If after 10 days, your symptoms have not improved, see your primary care doctor. You may have an acute sinus infection.If it lasts four weeks, you potentially have a sub-acute sinus infection that needs more aggressive treatment.
If symptoms last over 12 weeks, youre likely dealing with a chronic infection. After such prolonged symptoms, it can be difficult to distinguish sinus headaches from migraine headaches from severe allergies. After 12 weeks, diagnosing and treating the issue requires the medical expertise of an ENT.
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Research Into Antibiotics And Sinus Infections
The guidelines were triggered, in part, by studies finding that antibiotics may not make a difference. About 60% to 70% of people with sinus infections recover without antibiotics, according to the American Academy of Allergy, Asthma & Immunology.
In one study of symptom relief, patients given antibiotics generally did no better than patients not given antibiotics.
This study, published in the Journal of the American Medical Association, observed 240 patients with sinusitis. They were given one of four treatments: antibiotics alone, nasal steroid spray alone to reduce tissue swelling, both antibiotics and the spray, or no treatment.
Patients who got no treatment were as likely to get better than those who got the antibiotics. The nasal spray seemed to help people with less severe symptoms at the beginning of their sinus problem, and seemed to make those with more intense congestion worse.
The patients all had sinus symptoms that suggested a bacterial infection. Sinus problems are also caused by viruses, for which antibiotics definitely offer no help.
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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Using The Right Water During Saline Rinses
When using saline nasal rinses, tap water should always be boiled and then allowed to cool to ensure cleanliness distilled water or premixed solutions could also be used instead of regular tap water.
Other home remedies for sinus infections include:
- Drinking fluids: Drinking lots of fluids helps loosen and thin mucus. Avoid beverages that are caffeinated and alcoholic beverages that can dehydrate the body, which could thicken mucus.
- Breathing steam: Warm water is best . You can breathe in steam from either a bowl or shower.
- Humidifying the air: Use a cool air vaporizer or humidifier,particularly at night while sleeping.
- Avoiding environmental substances: Avoid tobacco smoke and chlorinated water that can dry up the mucus membranes and exacerbate symptoms.
- Implementing treatment measures: At the first sign of infection, use antihistamines and employ regular nasal rinses.
When To Take Antibioticsand When Other Treatments May Work Better
If youve been knocked out by sinus infection symptomsstuffiness, face pain or pressure, nasal dischargeyour doctor might recommend that you wait it out for a week or so before resorting to an antibiotic. And she or he might be right: Antibiotics are often not necessary for clearing up a sinus infection, according to recent research.
As a result, many health experts, including Zara Patel, M.D., a sinus infection expert and assistant professor of otolaryngology at Stanford University in Stanford, Calif., are urging doctors to think twice before prescribing antibiotics for sinus and other respiratory infections.
A 2016 study, published in JAMA, found that people who went to the doctor with a sinus infection were more likely to leave with a prescription for antibiotics than people seeing the doctor for any other reason . But some doctors, pointing to newer evidence, are starting to take a more cautious approach.
For acute sinusitis, there are very well-done studies indicating that antibiotics are not necessary in the vast majority of patients, and most people will be able to clear an infection on their own, Patel says.
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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.
Why Might Your Doctor Recommend Antibiotics For Sinusitis
You doctor may recommend antibiotics if:
- You have symptoms of a bacterial infection and you have not gotten better after 10 days, even with home treatment.
- Your symptoms are severe, or you have other problems, such as pus forming in your sinus cavities.
- You have had sinusitis for 12 weeks or longer .
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How Is Sinusitis Treated
Your treatment will depend on the cause of your sinusitis. Most of the time, treatment includes medicines and taking care of yourself at home. Medicines that are used most often include:
- , such as Sudafed, that are taken as pills or liquids. These can reduce swelling and improve sinus drainage.
- Over-the-counter pain medicine, such acetaminophen or ibuprofen .
- Antibiotics, which kill bacteria. Antibiotics will only work if your sinusitis is caused by bacteria. Most of the time, sinusitis is caused by a virus.
Do I Need Antibiotics For Sinus Infection
A person doesnt always require antibiotics to cure sinusitis. This is because most sinusitis will get better with different treatments. Additionally, since a virus causes most sinusitis conditions, antibiotics wont help a person get better and can cause unwanted side effects.
Side effects can range from minor rashes to severe health conditions, including antibiotic-resistant infections. You should discuss your symptoms with your physician and find the best treatment for your specific cause. For example, doctors only suggest antibiotics when they believe you have bacterial sinusitis.
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Recommendations For Nonantimicrobial Therapy
Intranasal steroids have not been conclusively shown to be of benefit in cases of acute sinusitis. One meta-analysis of 4 double-blind, placebo-controlled trials of intranasal corticosteroid treatment in acute rhinosinusitis supports its use as monotherapy or as an adjuvant therapy to antibiotics. However, a randomized, controlled trial of antibiotics and intranasal steroid showed no treatment benefit of intranasal steroids, either alone or with antibiotics.
In a literature study, van Loon et al concluded that only limited evidence exists regarding the efficacy of intranasal corticosteroids in relieving the symptoms of recurrent acute rhinosinusitis. The best evidence, according to the investigators, came from a single study, which had a low bias risk but only moderate directness of evidence according to that report, intranasal corticosteroids may shorten the time needed to achieve symptom relief.
No available data suggest that antihistamines are beneficial in acute sinusitis. In fact, antihistamines may cause harm by drying mucous membranes and decreasing clearance of secretions. Antihistamines are beneficial for reducing ostiomeatal obstruction in patients with allergies and acute sinusitis however, they are not recommended for routine use for patients with acute sinusitis. Antihistamines may complicate drainage by thickening and pooling sinonasal secretions.
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Treatments For Sinus Infections Other Than Antibiotics
#1: Saline Nasal Wash
Saline nasal wash can be a great way to thin out the mucous in the sinuses enough to clear out the blockage. I recommend starting this early on in the course of the illness to prevent the infection from worsening.
You can even make this at home using 2 cups of water and a 1/2 teaspoon of salt. I would add a 1/2 to 1 teaspoon of baking soda to prevent burning that can occur with use. There are also plenty of over the counter saline nasal sprays that you can purchase. You can use this 4-6 times per day.
Vaporizers are great because they can also thin out the mucous and make you feel a lot better. An easy home remedy, steam is probably the best way to use this treatment. Beware if you are an asthmatic as the steam could cause worsening of the asthma symptoms.
#3: Steroid Nasal Spray
Steroid nasal sprays such as Flonase have been my go to remedy recently and the great news is that they are now over the counter. The general recommendation is to use 1-2 sprays per nostril daily.
But I have found great relief using 2 sprays in each nostril twice daily. At these higher doses it is important to remember that you should use this short term, no more than 5-7 days.
These medications can significantly reduce inflammation allowing the congestion blockage to clear and significantly alleviate symptoms.
Guaifenesin such as Mucinex can certainly break up the mucous, allowing the congestion to clear more quickly.
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