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.
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.
Case & Commentary: Part 3
The patients hospital course was marked by multiorgan failure, septic shock, and spontaneous bowel perforation requiring hemicolectomy. Examination of the bowel showed Aspergillus, leading to a diagnosis of disseminated aspergillosis. Despite aggressive antifungal therapy, the patient ultimately succumbed to overwhelming infection and died.
This patient suffered a tragic outcome likely related to inappropriate prescribing of antibiotics. While the complications and ultimate outcome of this case are exceedingly rare, unfortunately, the problem of inappropriate antibiotic prescribing remains common. Over the past decade, antibiotic prescribing for ARIs has decreased in response to publicity and education regarding antimicrobial resistance. However, prescribing rates for viral infections remain high: in 2002, nearly half of adults with nonspecific ARIs were still prescribed antibiotics. Limited success in reducing overall antibiotic prescribing may be counteracted by a marked increase in prescribing of broad-spectrum antibiotics, the use of which doubled during the 1990s.
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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.
Dosage Of Doxycycline For Sinus Infection
The medicine of Doxycycline is available in the following forms-
- Liquid form
- Intravenous solution
Doctors prescribe to take this medicine in the form of pills for people suffering from sinusitis. There are various strengths of Doxycycline for sinus infection- 50, 75, 100, and 150 mg. In order to take the medicine, theres no need to crush or break it. Take one tablet whole while drinking one full glass of water with each dose.
Unless prescribed otherwise by doctors, usually the normal dose of oral form of doxycycline is 200 mg on the first day of the course. Followed by, changing the dosage to two 100 mg doses 12 hours apart. After this, maintaining a dose of 100 mg regularly for 7-10 days.
Although in rare cases, when the infection is severe, doctors can recommend higher doses such as 300 mg daily for 10 days.
Children over 8 years of age can take doxycycline for sinus infection. The dosage of the medicine depends on the childs weight.
Make sure that the course of the medicine is completed. Also, dont stop the medicine abruptly without proper consultation with the doctor.
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How Severe Are The Symptoms
Most sinus infections go away on their own without severe symptoms or complications. If a sinus infection is caused by bacteria, you may need antibiotics.
Many cases of COVID-19 may be mild or moderate. The World Health Organization estimates that
Heres what to do next whether you think that you have a sinus infection or COVID-19.
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How Can You Treat Sinusitis Without Antibiotics
Whether sinusitis is caused by bacteria or by a virus, most people get better even if they don’t take antibiotics.1 Home treatment for sinusitis can help relieve your symptoms. Here are some things you can do:
- Drink plenty of fluids to thin your mucus.
- Apply moist heat to your face for 5 to 10 minutes. Do this at least 3 times a day.
- Breathe warm, moist air from a steamy shower, a hot bath, or a sink filled with hot water.
- Use saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria. You can buy saline nose drops or sprays at a pharmacy or make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled. You may also find it helpful to gargle with warm salt water.
- Ask your doctor if you can take over-the-counter medicines such as pain relievers and decongestants to help you feel better. Be safe with medicines. Read and follow all instructions on the label.
- If you need to blow your nose, do it gently. Blowing your nose too hard may force thick mucus back into your sinuses. Keep both nostrils open when you blow your nose.
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Personal Stories About Antibiotics For Sinusitis
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I’ve had sinusitis a few times. So when my doctor suggested I take an antibiotic, I asked him if I really needed it. He said I would probably get better faster if I took the medicine. But I know from the other times that I’ll probably be okay in a week or so anyway. So we decided to wait and see instead of trying antibiotics.
I can’t wait to feel better. It seems like I’ve had bad sinus pain for the longest time. It’s been at least 2 weeks. Nasal sprays aren’t helping. I’m going to ask my doctor for antibiotics.
I thought I just had a bad cold, but my doctor says I have sinusitis caused by a bacterial infection. I’ve been doing all the right things at home, but it isn’t going away. I think antibiotics are the next step for me.
I thought I’d get my doctor to give me some antibiotics for my sinusitis. Then I’d be over it sooner. But it turns out that antibiotics won’t help me, since my sinusitis started as a cold. I didn’t know that antibiotics don’t always work. I’m going to wait it out instead.
John, age 52
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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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 .
Is It Safe To Take Amoxicillin During Pregnancy
Amoxicillin can be given to pregnant women. There are no known adverse effects on the fetus or newborn. Amoxicillin may also be given to women who are breastfeeding, but healthcare professionals may advise caution. Amoxicillin is present in human breast milk and may cause an infant to develop hypersensitivity to amoxicillin and similar antibiotics.
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Amoxicillin Dosage For Community
Pneumonia caught outside a hospital is called community-acquired pneumonia, and it is frequently caused by penicillin-susceptible bacteria. Pneumonia can be mild to severe, and in severe cases, it can be severe and potentially life-threatening, so amoxicillin is given in the highest doses until the infection clears.
Standard adult dosage for community-acquired pneumonia: 1 g every eight hours for at least five days
Maximum adult dosage: 3 g per day
Ways To Recognize Serious Signs Of Sinus Infections
The length of the infection is an important determinant of the seriousness of the infection.
I usually consider most infections less than 3 weeks to be viral or inflammation related to congestion. At this point, the best treatment is usually medications that decrease the congestion and inflammation. This in turn will alleviate the symptoms and ultimately cure the illness.
When the illness continues beyond 3 weeks, bacterial infection can begin to develop. Though antibiotics can be considered at this point, other treatments may still be the best answer if they have not yet been given a try.
#2: Mucous Color
I will dispel a myth right here and now. Yellowish/greenish mucous does not necessarily mean the infection is bacterial.
Viruses can cause the same color mucous. The reason for the mucous is generally not the actual bacteria or virus, but the bodys immune response to the intruder.
So dont worry just because you see a colored mucous when you blow your nose. This will also improve as the infection abates.
#3: Sinus Pain
Sinus pain can occur anytime throughout a sinus infection. This is normal and means there is inflammation in the sinuses, as we discussed previously.
However, severe pain, redness over the skin, hardened skin over the sinuses, or even a severe headache are not generally normal and can indicate a bacterial infection.
A fever can be caused by both viruses and bacteria. So how do you differentiate between the two?
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Is It Possible To Prevent Sinus Infections Or Sinusitis
Currently, there are no vaccines designed specifically against infectious sinusitis or sinus infections. However, there are vaccines against viruses and bacteria that may cause some infectious sinusitis. Vaccination against pathogens known to cause infectious sinusitis may indirectly reduce or prevent the chance of getting the disease however, no specific studies support this assumption. Fungal vaccines against sinusitis are not available, currently.
If you are prone to recurrent bouts of a “yearly sinus infection” it may be important to consider allergy testing to see if this is the underlying cause of the recurring problem. Treatment of the allergy may prevent secondary bacterial sinus infections. In addition, sinus infections may be due to other problems such as nasal polyps, tumors, or diseases that obstruct normal mucus flow. Treatment of these underlying causes may prevent recurrent sinus infections.
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What Tests Diagnose The Cause Of Sinus Infections And Sinusitis
Sinus infection is most often diagnosed based on the history and examination of a doctor. Because plain X-ray studies of the sinuses may be misleading and procedures such as CT and MRI scans, which are much more sensitive in their ability to diagnose a sinus infection, are so expensive and not available in most doctors’ offices, most sinus infections are initially diagnosed and treated based on clinical findings on examination. These physical findings may include
- redness and swelling of the nasal passages,
- purulent drainage from the nasal passages ,
- tenderness to percussion over the cheeks or forehead region of the sinuses, and
- swelling about the eyes and cheeks.
Occasionally, nasal secretions are examined for secreted cells that may help differentiate between infectious and allergic sinusitis. Infectious sinusitis may show specialized cells of infection while allergic sinusitis may show specialized white blood cells of allergy . Physicians prescribe antibiotics if a bacterial infection is suspected. Antibiotics are not effective against viral infections many physicians then treat the symptoms.
In addition, both rigid and flexible endoscopy has been used to obtain diagnostic material from sinuses. These procedures are usually done by an otolaryngologist under topical and local anesthesia. Occasionally, there may be a need to sedate the patient. Some investigators suggest that endoscopy specimens are comparable to those obtained by needle puncture.
How To Treat A Sinus Infection Without Antibiotics
Before you consider antibiotics, a sinus infection can be treated without leaving at home. Some of the home remedies to treat a sinus infection without antibiotics include:
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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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
If you have a high temperature or you do not feel well enough to do your normal activities, try to stay at home and avoid contact with other people until you feel better.
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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Does Using The Z Pack Add To Antibiotic Resistance
Overusing antibiotics threatens the safety of the population by contributing to antibiotic resistance.
Bacteria constantly adapt, which is how they continue to infect the human body. The more often bacteria interact with drugs such as antibiotics, the more they must adapt. This makes them stronger.
Antibiotic overuse may eventually lead to antibiotic resistance. This essentially means that the bacteria have become immune to the antibiotics. The estimate that each year in the U.S., antibiotic-resistant bacteria cause more than 23,000 deaths.
So, it is best to reserve the use of antibiotics for serious infections.