Thursday, June 16, 2022

Does A Sinus Infection Require Antibiotics

Runny Nose And Postnasal Drip

Are antibiotics needed for a sinus infection?

When you have a sinus infection, you may need to blow your nose often because of nasal discharge, which can be cloudy, green, or yellow. This discharge comes from your infected sinuses and drains into your nasal passages.

The discharge may also bypass your nose and drain down the back of your throat. You may feel a tickle, an itch, or even a sore throat.

This is called postnasal drip, and it may cause you to cough at night when youre lying down to sleep, and in the morning after getting up. It may also cause your voice to sound hoarse.

When To Call Your Provider

Occasionally, viral infections can set the stage for more complicated bacterial infections. If you experience any of the following, call your healthcare provider:

  • High fever
  • Shortness of breath or wheezing
  • Coughing up bloody mucus
  • Coughing so hard that you throw up
  • Feeling worse after 7-10 days of symptoms, especially if you have worsening headache, congestion, or sinus pain
  • If you dont start to feel better after 10 days of symptoms

To speak with a One Medical provider, sign up today and book an in-person or virtual visit.

Lingering Sinus Infection Or Chronic Runny Nose

A lingering sinus infection is different from a chronic runny nose. Chronic runny nose typically comes from allergies or other irritants in the air. However, this can turn into an infection over time.

When the sinuses become infected, the allergies, irritants, or viral cold have caused swelling in the nose thats blocked the drainage pathways. Consequently, fluid and mucous accumulate in the sinuses, where it has become infected with bacteria.

If youve been sick more than 10 days and begin to experience other symptoms like facial pressure, headache, and fever, youre dealing with more than a chronic runny nose.

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When Do I Actually Need Antibiotics For A Sinus Infection

There are several guidelines for determining if a patient actually needs antibiotics for a sinus infection. If you have thick, colorful nasal discharge and/or facial pain for at least 10 days, you meet the criteria. This does not mean if you have a slightly yellow or clear nasal discharge for 10 days having discharge from the nose for at least 4 weeks is normal in the case of sinus infections.

The second criterion is if your symptoms have improved but then got worse again, even if its been less than 10 days. This is referred to as double worsening and is a common scenario in bacterial infections. However, even then, you may want to follow what doctors suggest as watchful waiting. Wait 2 weeks and see if symptoms got better. Use over-the-counter medications and supportive care , as they often do the trick.

Sinus Infections Most Clear Up Without Antibiotics

Antibiotics for sinus infection

ROCHESTER, Minn. Sinus congestion and the common cold go hand in hand. Usually, congestion goes away within a week or so as the body fights off the illness. But sinus congestion and a feeling of sickness can linger and worsen, which may indicate a bacterial infection.

The October issue of Mayo Clinic Health Letter covers sinus problems, including symptoms of a bacterial infection and when antibiotic treatment may help clear out the stuffiness.

Sinus inflammation often begins with a cold, caused by a virus. When the sinuses become irritated and inflamed, sinus tissues swell. Expansion of these tissues can close off the ostia, the small openings that allow mucus to drain out of the sinus cavities. That blockage creates a feeling of stuffiness. Antibiotics have no effect on viruses and typically aren’t recommended within the first week of developing a cold.

The stagnant, moist environment of a blocked sinus cavity gives bacteria a place to grow and thrive. If bacterial infection develops, antibiotics may have a role in treatment. It’s tricky to determine whether sinusitis is caused by a virus or bacteria. The symptoms congestion, facial pain, drainage of mucus, cough, headache and feeling unwell can occur with both types of infections.

The likelihood of bacterial infection increases when:

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What Happens When Unnecessary Antibiotics Are Prescribed

Research shows that even bacterial infections can clear up on their own without antibiotics within one to two weeks. This means that the majority of the time, antibiotics are unnecessarily prescribed. Of all sinus infections, 85% clear up on their own, while only 15% do not. This 15% is the population that needs antibiotics.

Consuming antibiotics, even when you need them, increases side effects and bacterial resistance rates. This means that the more antibiotics prescribed, the more the bacteria will adapt to become resistant to that specific antibiotic. And there are only so many antibiotics to go around, so resistance should not be taken lightly. Thats why the overprescription of antibiotics is a public health emergency.

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:

  • Use saline spray two to three times per day in each nostril.
  • Use a nasal decongestant such as Afrin®, but not longer than three days.
  • Drink eight 8-ounce glasses of fluid per day.
  • Get plenty of rest.
  • Take an over-the-counter anti-inflammatory, such as acetaminophen or ibuprofen to help relieve the swelling of your sinuses.
  • 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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    Treating Sinus Infections: Dont Rush To Antibiotics

    Millions of people are prescribed antibiotics each year for sinus infections, a frequent complication of the common cold, hay fever, and other respiratory allergies. In fact, 15 to 21 percent of all antibiotic prescriptions for adults in outpatient care are for treating sinus infections. Unfortunately, most of those people dont need the drugs. Heres why:

    The drugs usually dont help.

    Sinus infections can be painful. People with the condition usually have a stuffy nose combined with yellow, green, or gray nasal discharge plus pain or pressure around the eyes, cheeks, forehead, or teeth that worsens when they bend over. But sinus infections almost always stem from a viral infection, not a bacterial oneand antibiotics dont work against viruses. Even when bacteria are the cause, the infections often clear up on their own in a week or so. And antibiotics dont help ease allergies, either.

    They can pose risks.

    About one in four people who take antibiotics have side effects, such as stomach problems, dizziness, or rashes. Those problems clear up soon after stopping the drugs, but in rare cases antibiotics can cause severe allergic reactions. Overuse of antibiotics also promotes the growth of bacteria that cant be controlled easily with drugs. That makes you more vulnerable to antibiotic-resistant infections and undermines the good that antibiotics can do for others.

    So when are antibiotics necessary?

    How should you treat sinus infections?

    Long Term Solutions For Chronic Sinusitis

    Do Antibiotics Help With Sinus Infections?

    Fortunately, chronic sinusitis does not have to be a permanent condition. If you are suffering or believe that you may be suffering with chronic sinusitis, Balloon Sinuplasty may be the best solution for you. Balloon Sinuplasty is a minimally invasive surgery that reshapes your anatomy to allow your sinuses to drain properly.

    As one of Houstons leading providers of Balloon Sinuplasty, Dr. Kaplan of Kaplan Sinus Relief can help provide you with effective, long term relief from sinusitis. Kaplan Sinus Relief even offers IV sedation for enhanced comfort during your Balloon Sinuplasty experience. Schedule a consultation today to discuss how Kaplan Sinus Relief can help relieve your chronic sinusitis.

    Location

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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

    When Do Symptoms First Appear

    The symptoms of a sinus infection often come on suddenly. COVID-19 symptoms can develop more gradually 2 to 14 days after exposure to SARS-CoV-2.

    A sinus infection can often happen after youve had a common viral illness, such as a cold or the flu. If your symptoms develop after youve already been sick, you may have a sinus infection.

    Viruses that cause a cold or flu tend to circulate in the fall and winter months. COVID-19 can occur any time of the year. While a sinus infection could develop following COVID-19, this hasnt yet been reported by research.

    A sinus infection can also occur after exposure to allergens or irritants, such as pollen, pet dander, and cigarette smoke. If you have allergies or were recently around an irritant, you may be at risk for a sinus infection.

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    Will My Sinus Infection Clear Up On Its Own

    The first few weeks of the common cold arent fun, but the acute sinusitis that can pop up afterwards doesnt help either. Sinus congestion and the common cold, unfortunately, 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.

    Sinus infections are caused when the cavities around your nasal passages become inflamed and swollen, which eventually interferes with drainage and causes mucus to build up. This tends to get annoying, because it makes breathing through the nose difficult. It also affects the area around your eyes and face, and can cause a throbbing headache.

    When a sinus infection hits, its always worse than what you remembered from the last time you had one. This may give you the idea that you need antibiotics, but most clear up without them. Antibiotics have no effect on viruses and arent recommended within the first week of developing a cold. About 70 percent of sinus infections go away within two weeks without antibiotics.

    Consider these other forms of treatments instead of antibiotics:

    • Over-the-counter pain relievers. Aspirins, acetaminophen or ibuprofen can help relieve temporary pain.
    • Saline nasal spray. This is used to spray into your nose several times a day to rinse your nasal passages. They can help to prevent and treat inflammation.

    Antibiotics only will be needed if the infection is severe, recurrent or persistent.

    Topics in this Post

    How Are Sinus Infections Treated

    Antibiotics For Sinus Infection

    Many sinus infections caused by a virus will resolve on their own without any treatment with antibiotics, Melinda said. This is important because if you dont need antibiotics, its better not to take them as they can cause side effects and long-term resistance. An infection caused by bacteria, however, will likely require antibiotics.

    Sometimes your health care provider may ask you to take over-the-counter medications to help your symptoms and monitor your condition further.

    Examples of over-the-counter medication include:

    • Saline nasal spray
    • Acetaminophen or ibuprofen for pain relief
    • A warm compress on your nose and forehead to relieve sinus pressure

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    How To Prevent A Sinus Infection

    Prevention is really the key, she said. Staying healthy by drinking plenty of fluids, getting adequate rest, decreasing stress and washing your hands are all good preventive steps.

    Make sure you get recommended vaccines such as the flu vaccine. Also, dont smoke and avoid secondhand smoke. And avoid close contract with others who have colds or other upper respiratory infections, Melinda said.

    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.

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    What To Expect With An Upper Respiratory Infection

    More than 90 percent of upper respiratory infections are caused by viruses. These infections create different symptoms at each stage. Most colds, flus and COVID-19 resolve in about a week, although some symptoms can take weeks to go away completely.

    Helen Xenos, a One Medical doctor in Chicago, describes the typical progression of the common cold:

    • Day 1: Fatigue, headache, sore or scratchy throat.
    • Day 2: Sore throat worsens, low fever, mild nasal congestion.
    • Day 3: Congestion worsens, sinus and ear pressure become very uncomfortable. It may be difficult to sleep.
    • Day 4: Mucus may turn yellow or green . Sore throat improves, but coughing begins.
    • Days 5-7: Energy and congestion improve.
    • 1 week+: Cough usually tapers off after a week, but can take up to 3-6 weeks to fully resolve.

    If your symptoms are much worse than these, such as coughing so hard you throw up, coughing up bloody mucus, difficulty breathing, or if you have a fever over 102°F, you might have something more serious going on, like pertussis or bacterial pneumonia.

    If a cold drags on for more than 2 weeks, it can turn into a sinus infection that causes pain around the eyes, nose and/or sinus headaches. Chest colds cause chest congestion and a hacking cough that drag on for a few weeks.

    The flu comes with similar symptoms but features a prominent fever, chills, headache, and body aches that usually last several days.

    About Author: Lisa Coon

    Sinus Infections Shouldn’t be Treated with Antibiotic

    Lisa Coon is a Writing Coordinator for OSF HealthCare, where she has worked since August 2016. A Peoria native, she is a graduate of Bradley University with a degree in journalism. Previously, she worked as a reporter and editor at several newspapers in Iowa and Illinois.She lives in Groveland with her husband and son. In her free time she likes to cook, bake and read. She freely admits that reality TV is a weakness, and she lives by the quote, The beach is good for the soul.

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    What To Do For Chronic Sinusitis

    If youre suffering from chronic sinusitis or you are getting frequent sinus infections you should see your doctor, says Dr. Sindwani.

    Your doctor will swab your nose to collect mucus. Culturing it in a laboratory will reveal which type of bacteria is causing the infection so the right antibiotic can be prescribed.

    Treat early sinus infection symptoms with rest, hydration and over-the-counter sprays and decongestants. But dont look for an antibiotic unless your illness extends beyond a week, he says. Then check in with your doctor for a prescription and let him or her know if your condition worsens.

    When Do Sinus Infections Need Antibiotic Treatment

    Antibiotics only are a sensible choice when a secondary bacterial infection accompanies the primary viral sinus infection. A clear sign of this will be high fever and facial pain that persists for more than five days. Moreover, such a secondary bacterial infection often will feel like a sudden relapse: your sinus already was improving and then suddenly worsens again. If thats the case, go see a doctor. Also, if your sinus infection shows no signs of abating after 10 days, you best get yourself checked by a doctor. This is particularly true for children and people with preexisting medical problems.

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    Is Your Sinus Infection Caused By A Virus Or Bacteria

    Physicians may not know if sinusitis is bacterial or viral, because the diagnosis is typically done by observing symptoms. Symptoms include:

    • Nasal congestion
    • Headache
    • Thick nasal or post-nasal drainage

    Sometimes other tests such as computed tomography scan or cultures are used to help make the diagnosis.

    Despite the recommendations that antibiotic use be judicious, they are still overused for sinusitis, according to many physicians who specialize in treating sinus problems.

    Some physicians say they give patients with sinusitis a prescription for antibiotics, and recommend they wait three to five days before filling it, and only fill it if symptoms are not better by then. A can be used to help relieve your symptoms and promote drainage.

    The longer symptoms last, the more likely a sinus problem is to be a bacterial infection, some experts say.

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