Risk Of Unnecessary Antibiotics For Sinus Infections
Taking unnecessary antibiotics for a sinus infection is not only ineffectual, but can actually be harmful to the patient. Risks of taking unneeded antibiotics include:
- Increased chance of getting an antibiotic-resistant infection at a later time
- Destruction of healthy stomach bacteria, which can allow harmful bacteria to grow
- Possible side effects, such as upset stomach, rash, or dizziness
- Allergic reaction
According to studies conducted by the American Academy of Allergy, Asthma, and Immunology , 60-70% of patients with sinus infections fully recover without the use of antibiotics. Additional research shows that almost 90% of U.S. adults diagnosed with acute sinusitis are prescribed antibiotics.
This overuse of antibiotics for sinus infections, as well as other conditions, can lead to antibiotic resistance, a state in which bacteria change over time as a reaction to antibiotic treatment, in order to survive and multiply, thus making the antibiotics less effective.
What About Pain Treatment
Until the antibiotic kills all of the infection, you may need a pain reliever. The American Dental Association recommends that pain treatment start with a prescription or over-the-counter nonsteroidal anti-inflammatory drug , such as:
In some cases, an NSAID may be combined with acetaminophen .
In the past, dental pain was more often treated with prescription opioids, but the ADA notes that NSAIDs have been shown to be more effective for tooth pain. If an opioid is needed, a doctor or dentist will prescribe it at the lowest effective dose for a limited amount of time.
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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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.
When Is A Z
Spoiler alert: its not! Because its so easy to use, the Z-Pak used to be a go-to prescription for sinus infections. But it turns out that only a minority of these prescriptions are appropriate because the majority of sinus infections are viral and not bacterial. In fact, studies have found that about a third of antibiotic prescriptions for sinus infections, sore throats, and ear infections arent even necessary. Overprescribing antibiotics increases the chance that bacteria will become resistant to them and disrupt the gut bacterial flora for months. Indeed, azithromycin is no longer recommended for bacterial sinus infections due to the risk of resistance.
If you have a sinus infection, expect to feel lousy for several days. After all, your body is waging war against an infection. You might experience:
A runny nose
A sore throat
Youre also likely to feel more tired and achy and maybe even experience a low-grade fever. Most people improve within a week, but symptoms can last up to 2 weeks. Coughs can linger for a week after that.
Treating a sinus infection boils down to whether its viral or bacterial. Colds, for example, are viral. And antibiotics like the Z-Pak are not effective against viral infections. In fact, viral sinus infections have no cure. Treatment is aimed at managing symptoms and includes:
If you still dont feel better, your healthcare provider may suggest nasal or lung inhalers for other symptoms.
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What Are The Symptoms Of Omicron
While there are subtle differences between the latest coronavirus strain and previous ones, so far the signs of infection look pretty similar.
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With cases of Omicron rising throughout the United States, Americans are scrambling to distinguish the symptoms of this new variant from those of other coronavirus variants, including Delta.
Most P.C.R. and rapid antigen tests can detect Omicron the Food and Drug Administration has noted there are only a few tests that dont but results do not indicate to the user which variant they are infected with, leaving people to guess.
Some symptom differences have emerged from preliminary data, but experts are not certain they are meaningful. Data released last week from South Africas largest private health insurer, for instance, suggest that South Africans with Omicron often develop a scratchy or sore throat along with nasal congestion, a dry cough and muscle pain, especially low back pain.
Its likely that the symptoms of Omicron will resemble Deltas more than they differ.
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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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.
When To See A Vet For Your Dogs Sinus Infection
If your dogs symptoms have lasted more than 48 hours, its time to bring them to the vet for diagnosis. To discover the cause of your dogs sinus infection, your veterinarian may take X-rays, perform an endoscopy, take a nasal biopsy or culture, or run blood work.
Depending on the cause, your vet may prescribe antibiotics or antifungal therapy, perform surgery, or administer radiation therapy. Some dogs may have chronic sinus infections, which require ongoing treatment to manage signs that occasionally pop up.
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Amoxicillin Dosage For Sinus Infection
According to the official literature, the dosage of amoxicillin for adults can range from 250 mg. to 1 gm three times a day, depending on the severity of the infection. For children, 20 mg. per kg. body weight can be given in three divided doses.
In the case of mild to moderate infections, your doctor may prescribe 250 mg. three times a day or 500 mg. two times a day. For severe sinus infections, 500 mg three times a day or 875 mg two times a day can be recommended by the doctors.
For children, 20 mg. / kg. body weight three times a day or 25 mg. / kg. body weight two times a day is normally recommended by the doctors. In severe infections, the doctors may prescribe 40 mg. / kg. body weight three times a day or 45 mg. / kg. body weight two times a day.
Amoxicillin dosage depends on the age, body mass, and health condition of the patients. Your doctor may change the dose and duration of the treatment by monitoring certain health parameters during the treatment.
So, always take amoxicillin under the recommendation and supervision of a credible practitioner. You should never take amoxicillin or any other medicine on your own because it may affect your health condition, particularly if you have any liver or kidney issues.
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,
- Allergist or Immunologist.
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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.
People With Sinus Infections Stay On Antibiotics Too Long
By Lisa Rapaport, Reuters Health
5 Min Read
– Most people prescribed antibiotics for sinus infections are on treatment courses of 10 days or longer even though infectious disease doctors recommend five to seven days for uncomplicated cases, a U.S. study suggests.
Researchers examined data from a sample representing an estimated 3.7 million adults treated for sinusitis and prescribed antibiotics in 2016. Overall, 70 percent of antibiotics prescribed were for 10 days or longer, the study found.
Any time antibiotics are used, they can cause side effects and lead to antibiotic resistance, said senior study author Dr. Katherine Fleming-Dutra, deputy director of the Office of Antibiotic Stewardship at the U.S. Centers for Disease Control and Prevention in Atlanta.
This is why it is so important to only use antibiotics when they are needed and to use the right antibiotic for the minimum effective duration, Fleming-Dutra said by email.
Common side effects of antibiotics can include rash, dizziness, nausea, diarrhea and yeast infections, she said. More serious side effects may include life-threatening allergic reactions and Clostridium difficile infection, which causes diarrhea that can lead to severe colon damage and death.
Antibiotic resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them and can make infections harder to treat.
SOURCE: bit.ly/2Gpq29Z JAMA Internal Medicine, online March 26, 2018.
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Is There A Best Antibiotic For A Sinus Infection
In most cases, a sinus infection doesnt need antibiotics it will go away on its own. Viruses are usually the cause of sinusitis. However, if yours is due to a bacterial infection, your doctor may prescribe antibiotic treatment to shorten your recovery time and relieve your symptoms. Amoxicillin, with or without clavulanate,is a first-line antibiotic prescribed for sinus infections, but your doctor will prescribe the antibiotic thats best for your condition.
Only take antibiotics if your doctor prescribes them. Dont try to self-treat your sinus infection by taking leftover antibiotics you may have on hand. Taking antibiotics when you dont need them wont help your condition and could cause serious health problems.
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.
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Should You Treat A Sinus Infection With Antibiotics
Over the past few months Ive seen patient after patient drag themselves to the clinic with coughing, sneezing, headaches and green or yellow nasal discharge, sometimes accompanied by ear and tooth pain. Some people with infection may experience fevers, chills or night sweats signs that the body is fighting a virus or bacteria. These are symptoms I expect as a primary care doctor especially during the spring seasons. They are the telltale signs of sinusitis. But if that sums up symptoms you have, do you need antibiotics? The question may be more complicated than you think.
Each year, more than 30 million Americans endure sinusitis an inflammation of sinus spaces surrounding the nose that makes it difficult to drain fluid that normally flows through the sinuses. Much like a detective weighing clues, us health providers use symptom severity and duration to determine the cause of a patients sickness.
The World Health Organization has called antibiotic resistance one of the biggest threats to global health, saying misuse of antibiotics in humans and animals is accelerating the process.
At a health professionals discretion, antibiotics can be prescribed if a person appears very sick or has any underlying chronic disease that may make them prone to becoming sicker.
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
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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.