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.
âOur findings support recommendations to avoid routine antibiotic treatment for patients with uncomplicated acute rhinosinusitis,â 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.
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.
What Is Sinusitis In Children
Sinusitis is an infection of the sinuses. These infections often happen after a cold or with allergies. There are 3 types of sinusitis:
Short-term . Symptoms of this type of infection last less than 12 weeks and get better with the correct treatment.
Long-term . These symptoms last longer than 12 weeks.
Recurrent. This means the infection comes back again and again. It means 3 or more episodes of acute sinusitis in a year.
The sinuses are air-filled spaces near the nose. They are lined with mucous membranes. There are 4 different sinuses:
Ethmoid sinus. Located around the bridge of the nose. This sinus is present at birth, and continues to grow.
Maxillary sinus. Located around the cheeks. This sinus is also present at birth, and continues to grow.
Frontal sinus. Located in the area of the forehead. This sinus does not develop until around age 7.
Sphenoid sinus. Located deep behind the nose. This sinus does not develop until the teen years.
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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.
How Does Amoxicillin Work
After starting therapy, amoxicillin will begin to work faster than many other antibiotics since it is âbactericidalâ, which means it kills bacteria. This is in contrast to âbacteriostaticâ antibiotics, which slow the growth and reproduction of bacteria but donât 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.
Amoxicillinâs ability to interfere with PBPs in the cell wall ultimately leads to cell lysis .
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How Effective Is Amoxicillin For A Sinus Infection
Many sinus infections that are caused by bacteria will not go away with the use of over-the-counter medications and home treatments. For this reason, a doctor will often prescribe amoxicillinfor a sinus infection. The antibiotic is generally taken over a period of 10 days to two weeks, during which time the medication will most likely succeed in overcoming the illness.
A sinus infection occurs when the sinuses, air-filled chambers of bone connected to the nasal passages, become inflamed, causing pressure in the head, headaches, nasal discharge, and other symptoms. If the infection is persistent and occurs with severe symptoms, it may be caused by a bacterial infection. In many cases, amoxicillin is prescribed to take care of this problem.
Amoxicillin for a sinus infection is available in the form of a pill, a liquid, or a nasal spray. Adults are generally prescribed the pill form of the antibiotic and are instructed to take a relatively high dose of the antibiotic for 10 to 14 days. In general, children and those who are unable to swallow a whole pill are given the liquid form of amoxicillin for sinus infections. If a sinus infection is considered chronic, or long-lasting, lower doses of this antibiotic may be prescribed for a longer length of time.
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Common Antibiotics For Sinus Infections
Antibiotics may be prescribed when symptoms of a sinus infection warrant such treatment. Common antibiotics for sinus infection include:
- Levaquin : Although this drug is often prescribed as a first line of therapy for sinusitis, it has serious side effects and should only be used as a last resort.
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What Are The Best Antibiotics For Sinus Infection Do Doctors Prescribe For You
There are many antibiotics that your doctor or physician may prescribe to help treat your sinus infection. Some of these may even be familiar to you.
These antibiotics are effective in treating sinus infection, however, these drugs do carry side effects. You should only be taken according to what your doctor or physician has prescribed. Always follow their instructions to achieve the best results.
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Key Points About Sinusitis In Children
Sinusitis is an infection of the sinuses.
When discharge from the nose is blocked, bacteria may start to grow. This leads to a sinus infection or sinusitis.
Acute sinusitis may get better on its own. But if it doesnt, medicine can be prescribed.
For chronic sinusitis, the healthcare provider may refer your child to an ear, nose, and throat doctor for testing and treatment.
To help prevent sinusitis, have your child use saline sprays or washes to keep the noise moist. Use a humidifier in dry inside areas.
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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:
- 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.
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.
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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.
Algorithm For Use Of Antibiotics In Acute Sinusitis
Adapted from Chow AW, Benninger MS, Brook I, et al: IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clinical Infectious Diseases 54 :10415 .
In exacerbations of chronic sinusitis in children or adults, the same antibiotics are used, but treatment is given for 4 to 6 weeks. The sensitivities of pathogens isolated from the sinus exudate and the patients response to treatment guide subsequent therapy.
Sinusitis unresponsive to antibiotic therapy may require surgery to improve ventilation and drainage and to remove inspissated mucopurulent material, epithelial debris, and hypertrophic mucous membrane. These procedures usually are done intranasally with the aid of an endoscope. Chronic frontal sinusitis may be managed either with osteoplastic obliteration of the frontal sinuses or endoscopically in selected patients. The use of intraoperative computer-aided surgery to localize disease and prevent injury to surrounding contiguous structures has become common. Nasal obstruction that is contributing to poor drainage may also require surgery.
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When Should You Use Antibiotics
You usually need an antibiotic when you have an infection that is caused by bacteria, and the infection is not going away on its own. This may be the case when:
- Your symptoms last more than 10 days.
- Your symptoms start to get better, but then get worse again.
- Your symptoms are very severe. You should get immediate treatment if:
- You have severe pain and tenderness in the area around your nose and eyes.
- You have signs of a skin infectionsuch as a hot, red rash that spreads quickly.
- You have a fever over 102°F.
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
How To Use Coconut Oil:
Coconut oil can be used in a variety of ways to treat sinus infections. Adding a tablespoon to tea or coffee and drinking it is one method. Likewise, the oil can be swished in the mouth and spat back out using an oil pulling method. Finally, the oil can also be used as a nasal rinse by using a dropper or neti pot. To use this method, the oil must be in its liquid form. Adding the oil to purified water with salt and/or baking soda is also effective for rinsing the nasal passages.
Many common treatments of sinus infections can actually lead to worsening of the condition. Coconut oil, however, naturally eliminates the infection, soothing the sinuses, and relieving inflammation as it does so. Continue reading below for reviews from Earth Clinic contributors around the world who have tested coconut oil for sinus infections.
Tried this coconut oil remedy? Did it work? Please send us your review!
What Are Complications Of Sinus Infection Or Sinusitis
While serious complications do not occur frequently, it is possible for a sinus infection to cause a direct extension of infection into the brain through a sinus wall, creating a life-threatening emergency .
In addition, other adjacent structures can become infected and develop problems, such as osteomyelitis of bones in the skull and infection around the eye . Rarely, these infections may cause death. The most susceptible individuals to complications are patients with suppressed immune systems, diabetes, and relatively rarely from multiple trauma injuries that may occur in natural disasters.
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What Are The Most Common Antibiotics Used For Sinusitis
Amoxicillin remains the drug of choice for acute, uncomplicated bacterial sinusitis. Amoxicillin is most effective when given frequently enough to sustain adequate levels in the infected tissue. While often prescribed twice daily, it is even more effective if taken in 3 or 4 divided doses. Amoxicillin is typically prescribed for 7-10 days at a time. While it is critical to finish the entire 10 day course of antibiotics when treating strep throat, there is evidence that shorter courses of treatment may be sufficient for most cases of sinusitis. Amoxicillin is closely related to the parent compound penicillin and should not be prescribed in patients who are penicillin allergic.
Cephalosporins and Augmentin are considered broad-spectrum antibiotics because they have enhanced effectiveness against a wider range of bacteria, including those that are resistant to ordinary penicillin or amoxicillin. If the patient does not improve within the first week on amoxicillin, a change to Augmentin or to a cephalosporin such as Ceftin, Cefzil, Omnicef, or Suprax is reasonable. Although these drugs have a similar mechanism of action to penicillin, they generally can be taken in adequate doses once or twice daily. These medications should be used with extreme caution in patients with a history of penicillin allergy, as cross-reaction may occur.
What Decongestants And Nasal Sprays Soothe Or Cure Sinus Infections Or Sinusitis
Taking decongestants and mucolytics orally may be helpful in assisting drainage of sinus infection.
The treatment of chronic forms of sinus infection requires longer courses of medications, such as Augmentin, and may require a sinus drainage procedure. This drainage typically requires a surgical operation to open the blocked sinus under general anesthesia. In general, antihistamines should be avoided unless it is felt that the sinusitis sinus infection is due to allergies, such as from pollens, dander, or other environmental causes.
It is likely that the use of a topical nasal steroid spray will help reduce swelling in the allergic individual without the drying that is caused by using antihistamines although both are occasionally used. Oral steroids may be prescribed to reduce acute inflammation and to help with chronic inflammation in cases with or without polyps and in allergic fungal sinusitis.
In many people, allergic sinusitis develops first, and later, bacterial infection occurs. For these individuals, early treatment of allergic sinusitis may prevent the development of secondary bacterial sinusitis.
In rare instances or in natural disasters, fungal infections may develop in debilitated people. Death rates of 50%-85% have been reported for patients with these sinus infections. Treatment relies on early diagnosis followed by immediate surgical debridement, antifungal drugs, , and stabilizing any underlying health problem such as diabetes.
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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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What If You Dont 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:
âAmoxicillin 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.â
So overall, amoxicillin is absorbed quickly after taking a dose by mouth, and you should feel improvement in your symptoms within72 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:
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