When To Seek Medical Care
See a doctor if you have:
- Severe symptoms, such as severe headache or facial pain.
- Symptoms that get worse after initially improving.
- Symptoms lasting more than 10 days without improvement.
- Fever longer than 3-4 days.
You should also seek medical care if you have had multiple sinus infections in the past year.
This list is not all-inclusive. Please see a doctor for any symptom that is severe or concerning.
Other conditions can cause symptoms similar to a sinus infection, including:
- Seasonal allergies
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.
What Causes Chronic Sinus Infection
Multiple factors acting together usually contribute to chronic sinusitis.
People with allergies are more prone to develop chronic sinusitis. About one in five people with chronic sinusitis also have asthma. This is because the linings of your nose and sinuses are in continuation with the linings of your lungs. These people are also likely to have nasal polyps .
A bacterial or viral infection can also trigger the condition. The infection is often low grade. The bacteria confine themselves in stubborn biofilms, making it difficult for your immune system or antibiotics to find and attack them.
An overlap of additional factors such as smoking, environmental pollutants, and deviated septum, further complicate the picture of chronic sinusitis.
It would be more appropriate to say that if youre already prone to allergies and nasal polyps, it becomes easier for harmful bugs, especially fungi to penetrate your sinuses. Likewise, a weak immune system makes you more susceptible to catch bacterial, viral, or fungal sinus infection.
A sinus that is inflamed and swollen can no longer sweep away the excess mucus and harmful agents due to the blockage of tiny hairs that facilitate this function.
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Can Sinus Infections Or Sinusitis Be Prevented
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.
Feel Better Sooner Without Antibiotics
Instead of taking antibiotics for sinusitis, Consumer Reports chief medical adviser, Marvin M. Lipman, M.D., recommends that you get plenty of rest, rinse your nose with a saltwater sinus rinse or spray, drink warm fluids, and inhale steam from a hot bath, shower, or kettle. For pain, he says, try an over-the-counter pain reliever such as acetaminophen or ibuprofen .
If needed, your doctor can prescribe a prescription corticosteroid spray, such as fluticasone or triamcinolone. A systematic review published in JAMA in 2015 found that after saline irrigation, the second-best treatment for chronic sinusitis was a topical corticosteroid spray for a few days.
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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.
What If You Don’t Start To Feel Better
Most studies, such as the guidelines to treat ear infections in children, recommend that if no clinical improvement is seen within 48-72 hours of starting amoxicillin, therapy should be reevaluated.
Similarly, the American Academy of Pediatrics guidelines for the treatment of sinusitis states the following:
“Amoxicillin with or without clavulanate is the firstline treatment of acute bacterial sinusitis. Clinicians should reassess initial management if there is either a caregiver report of worsening or failure to improve within 72 hours of initial management.”
So overall, amoxicillin is absorbed quickly after taking a dose by mouth, and you should feel improvement in your symptoms within 72 hours. If you do not, it is important to speak with your doctor as your infection may be resistant to the antibiotic, and alternative therapy options should be considered.
Alternative therapies include:
Sinus Infection Antibiotics No Help
Antibiotics, Steroid Spray No Help for Adult Sinus Infections
One of the most common complications of the common cold or flu is a sinus infection. The symptoms: a stuffy nose a thick, dark-colored nasal discharge and head pain.
You’ve very likely had such an infection. And if, like 25 million other Americans, you went to a U.S. doctor, there’s a 90% chance you got a prescription for antibiotics.
You very likely had some side effects from that antibiotic. But it’s extremely unlikely the antibiotics you took were much help, according to a study by Ian G. Williamson, MD, senior lecturer at the University of Southampton, England.
“We are confident that if there is an effect of antibiotics on acute sinus infections, it is not very big — certainly not as big as people have been led to believe,” Williamson tells WebMD.
Williamson and colleagues studied 240 patients ages 16 and older whose symptoms suggested that they had a sinus infection caused by bacteria. Viruses also cause sinus infections, but antibiotics do not help viral infections.
Study patients received antibiotic treatment with amoxicillin, an antibiotic often used for bacterial sinus infections, with or without nasal steroid sprays. A fourth of the patients received no treatment at all, but just got inactive placebo pills and placebo sprays.
Do I Need Antibiotics For A Sinus Infection
Sinus infections can be extremely frustrating, especially when you have a headache and facial pain that doesnt go away, coupled with the inability to breathe through your nose. You want immediate relief, but unfortunately, it takes at least a few days to start feeling better. You may think you need to go to the doctor and get antibiotics for a sinus infection, but this isnt always the case.
In the winter months, sinus infections, colds, bronchitis, pneumonia, the flu, and other respiratory infections are common. Patients think that if they come down with an illness, they will require antibiotics. However, most sinus infections dont require antibiotics.
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Killer Sinus Infection How To Tell If Yours Is Viral Or Bacterial
You know the symptoms: nasal congestion, facial pressure, pain, fever, too much mucus. Ugh. Its probably another sinus infection.
But is your infection caused by a virus or bacteria and does it really matter?
It does matter. Doctors treat viral and bacterial sinus infections differently. Here is what you need to know about both kinds of infection and how to treat them.
Viral or bacterial?
Most sinus infections are viral, and most are caused by the virus that causes the common cold. How can you tell, based on symptoms, whether your infection is viral or bacterial?
Normally, you can’t.
Symptoms like bad breath, yellow or green mucus, fever and headache are not reliable signs of a bacterial infection. They can be present with viral infections, too. Even your doctor cant tell if your infection is viral or bacterial based solely on symptoms or an exam.
Instead, your doctor looks at symptom duration to determine the source of your infection. A viral sinus infection will usually start to improve after five to seven days. A bacterial sinus infection will often persist for seven to 10 days or longer, and may actually worsen after seven days.
4 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 care:
Use saline spray two to three times per day in each nostril.
Drink eight 8-ounce glasses of fluid per day.
Get plenty of rest.
What to do for chronic sinusitis
What Is A Sinus Infection
The sinuses are cavities in the head that are filled with air. These air-filled pockets are lined with a very thin layer of mucus that functions to collect particles from the air that are breathed in, such as dust, germs, or other particles.
Very small hair-like projections function to sweep the mucus, along with any particles trapped inside of the mucus. The germ- or dirt-filled mucus then slides down the back of the throat and into the stomach where stomach acid works to kill any germs.
When a sinus infection occurs, this natural process involving mucus flow is blocked.
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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.
What Is A Sinus Infection Or Sinusitis
Inflammation of the air cavities within the passages of the nose is referred to as sinusitis. Sinusitis can be caused by infection , but also can be caused by allergy and chemical irritation of the sinuses. A sinus infection occurs when a virus, bacterium, or fungus grows within a sinus.
Sinusitis is one of the more common conditions that can afflict people throughout their lives. Sinusitis commonly occurs when environmental pollens irritate the nasal passages, such as with hay fever. Sinusitis can also result from irritants, such as chemicals or the use and/or abuse of over-the-counter nasal sprays, and illegal substances that may be snorted or inhaled through the nose. About 30 million adults have “sinusitis.” Colds differ from sinusitis and are only caused by viruses and last about seven to 10 days while sinusitis may have many different causes , and usually last longer with more pronounced and variable symptoms.
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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.
Price Of Amoxicillin For Sinus
The average price of Amoxicillin for Sinus 500 mg Tablet is around Rs. 67.87 in the Indian market.
|Average price of Amoxicillin 500 mg strip of 10 tablets||Rs. 67.87|
The medicine is available in a lot of forms-
- Powder for oral suspension
You should take amoxicillin exactly as prescribed by the doctor. You should also follow all the directions given on the label word-to-word and read the instruction sheet thoroughly.
One should take the medicine at the same hour of the day daily. If you are taking oral suspension, then shake the bottle before use. You can mix it with water, milk, baby formula, fruit juice or ginger ale.
In case you are taking tablets, do not crush, chew, or break the tablet before gulping it. Lastly, do not change the dose or schedule without consulting the doctor first.
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Antibiotics Fail To Clear Up Sinus Infections
30 May 13
Antibiotics should not be taken to treat run-of-the mill sinus infections, according to a new study.
After three days of treatment, people taking amoxicillin saw no better improvement in their symptoms than people taking a placebo, the study showed. The research involved 166 participants who took either the antibiotic amoxicillin or a placebo to treat their sinus infections for 10 days, and did not know which they were taking.
“Our findings support recommendations to avoid routine antibiotic treatment for patients with uncomplicated acute rhinosinusitis,” the researchers wrote in their study, to be published tomorrow in the Journal of the American Medical Association.
The researchers focused on day 3 of the treatment because most sinus infection symptoms clear up on their own by day 10, according to the study. The symptoms most frequently reported were congestion, pain or pressure in the face and coughing.
Some previous studies have found that antibiotics make the symptoms of sinus infections to clear up faster, but other studies have not found this benefit, according to the study. Moreover, analyses that have looked at the results of many studies together have found little evidence of a benefit. Still, of all prescriptions for antibiotics in the U.S., 20 percent are written to treat sinus infections, according to the study.
Neither group reported serious side effects about a fourth of the people in each group experienced a headache, according to the study.
How Fast Does Amoxicillin Work
Amoxicillin will begin to work quickly after taking a dose. It’s quickly absorbed, and peak concentrations in the blood occur around 1 to 2 hours after administration.
However, in general, it will take between 24-72 hours to notice an improvement in symptoms. So, while amoxicillin goes to work quickly, it still takes time for our immune system to clear toxins and reduce inflammation.
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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
- 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.
How Does Amoxicillin Work
After starting therapy, amoxicillin will begin to work faster than many other antibiotics since it is “bactericidal“, which means it kills bacteria. This is in contrast to “bacteriostatic” antibiotics, which slow the growth and reproduction of bacteria but don’t kill them directly.
Specifically, amoxicillin works by inhibiting bacterial cell wall synthesis by binding to what is known as penicillin-binding proteins . These are located inside the bacterial cell wall.
Amoxicillin’s ability to interfere with PBPs in the cell wall ultimately leads to cell lysis .
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