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.
Antibiotics And Sinus Infections
When a sinus infection hits, it seems 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 aren’t recommended within the first week of developing a cold. About 70% of sinus infections go away within two weeks without antibiotics.
Consider these other forms of treatments instead of antibiotics:
- These medications are available for over-the-counter purchase. Be careful to only take these medications for a few days at most, as they can cause the return of more severe congestions.
- 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. It can help to prevent and treat inflammation.
Antibiotics only will be needed if the infection is severe, recurrent or persistent.
The likelihood of bacterial infection increases when:
- Symptoms last seven days or more, particularly when symptoms initially improve and then worsen.
- Mucus is thick and yellow or green in color.
- There is facial or sinus tenderness, particularly if it’s worse on one side of the face.
- Pain is present in the upper teeth and is worse on one side of the face.
If the infection becomes severe, recurrent or persistent, contact your provider.
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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. Do I maybe need antibiotics? she asked.
What Are Common Side Effects Of Sinus Infection Medications
The most common side effects of sinus infection medications differ by the type of medication you use. Decongestants tend to cause nervousness, insomnia, and a loss of appetite. Side effects of antibiotics include nausea, vomiting, and diarrhea. Antihistamines and steroids can cause dizziness and sleep disturbances.
This is not an exhaustive list of sinus infection medication side effects. If you experience any adverse reactions from a medication or treatment, its always best to consult with your healthcare provider.
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Dealing With Recurring Or Severe Sinus Infections
If you have frequent and/or long-lasting sinus infections, your doctor may prescribe imaging tests to determine the cause of your problem. If appropriate, a surgeon can remove blockages and enlarge the sinus passages to help the sinuses drain more easily. Better drainage can make it less likely that a sinus infection will develop.
If you suffer from recurring sinus infections or infections that linger, talk with your Baptist Health physician about your symptoms and the best treatments for you. If you dont have a doctor, you can find one in our online provider directory.
Next Steps and Useful Resources
When Does Antibiotic Resistance Occur
Antibiotic resistance occurs in a persons own body and within the community when certain drugs no longer work for a specific type of germ. This can occur when bacteria change in response to exposure to antibiotics so that the antibiotics no longer work efficiently against the bacteria.
Unfortunately, it’s hard to know if a sinus infection is bacterial, viral, or has other causes based on symptoms alone. Because viral sinus infections tend to improve in 5 to 7 days, healthcare providers will usually only prescribe antibiotics if your symptoms go on for longer than this. A sinus infection that persists for longer than a week or continues to get worse during this time period is more likely to be bacterial.
Therefore, allergists and other specialists recommend limiting the use of antibiotics unless:
- Symptoms last over seven to 10 days
- A fever is present
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Other Remedies For Symptom Relief
Staying hydrated can help thin mucus to ease congestion.
Drinking hot liquids such as tea and broth may help relieve your symptoms. Breathing in moist air may also help relieve the discomfort that comes with nasal congestion. Try breathing in steam from the shower, a bowl of hot water, or a mug of tea.
If your voice is hoarse, rest it by avoiding yelling, whispering, and singing.
Placing a warm compress over the inflamed area can help reduce pressure and provide relief.
damages the natural protective elements of your nose, mouth, throat, and respiratory system.
If you smoke, consider quitting. Ask a doctor if you need help or are interested in quitting. Quitting may help prevent future episodes of both acute and chronic sinusitis.
Wash your hands frequently, especially during cold and flu seasons, to keep your sinuses from becoming irritated or infected by viruses or bacteria on your hands.
Using a humidifier during the cooler, dryer months may also help prevent sinus infections.
Talk with a doctor to see if allergies are causing your sinusitis. If youre allergic to something that causes persistent sinus symptoms, you will likely need to treat your allergies to relieve your sinus infection.
You may need to seek an allergy specialist to determine the cause of the allergy. The specialist may suggest:
- avoiding the allergen
- doing allergic immunotherapy
Keeping your allergies under control can help prevent repeated episodes of sinusitis.
You Probably Dont Need Antibiotics For Sinus Infections Or Sinusitis
If you were wondering whether you needed antibiotics for a sinus infection, heres why antibiotics are rarely the right treatment for chronic sinusitis. According to the CDC, 9 out of 10 sinus infections are caused by viruses, while only 1 out of 10 cases of sinusitis are caused by bacterial infections. Antibiotics can only treat bacterial infections, and therefore an antibiotic treatment will not be effective for most sinus infections caused by chronic sinusitis.
For people with chronic sinusitis, taking antibiotics to clear up as many as four sinus infections a year can have some unintended long term consequences. The more often you take antibiotics for basic illnesses, the worse your body becomes at actually fighting them off. Not only will your sinus infections keep coming back, the effectiveness of antibiotics against other, more serious infections could become compromised.
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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.
Sinus Infection Symptoms Follow A Different Path Than Colds
You may be able to tell if you have a sinus infection, depending on how your symptoms progress.
Most cases begin as a common cold, and symptoms usually go away in 7 to 10 days. In some cases, a bacterial infection develops.
Typically, the length of symptoms helps us tell if the patient has a sinus infection or a cold, Dr. Hur says. Cold symptoms usually improve within one to two weeks, though a cold can evolve into a sinus infection, which generally lasts longer without treatment. Also, a cold can affect other areas beyond the nose, such as the throat.
If you have bacterial sinusitis, you might experience the following:
- Fever greater than 102 degrees Fahrenheit
- Nasal drainage or postnasal drainage that looks very discolored or thick, like pus
- A double worsening, meaning that you start to get better but then feel worse again
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Common Symptoms Of A Bacterial Sinus Infection
- Same symptoms of a viral sinus infection
- Symptoms start to worsen after 7-10 days
- Fever that lasts multiple days in a row
- Typically requires antibiotics
So, lets go back to the original question: Can you have a sinus infection without a fever? As you can now see, having or not having a fever wont always help you determine if you have a sinus infection.
However, one thing that you can say with more certainty is that you probably have a bacterial sinus infection if you have a fever that lasts multiple days and does not let up.
Sinusitis May Require A Call To Your Doctor
Although many sinus infections go away on their own, you may need to see a doctor if:
- You have severe symptoms from the beginning
- You start to get better but then feel worse again
- Have symptoms that last more than 10 days
You should seek care from a doctor if sinusitis impacts your quality of life and hasnt improved with over-the-counter treatments, Dr. Hur says.
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Sinusitis May Or May Not Need Antibiotics
You might not need antibiotics however, for acute sinusitis due to a bacterial infection, antibiotics can help decrease the length of symptoms and lessen their severity.
If a sinus infection lasts more than one to two weeks, it is more likely to be a bacterial infection, so antibiotics and/or oral steroids may need to be prescribed, Dr. Hur says. Sinus infections that do not improve with antibiotics may need to be treated with surgery.
Talk to your doctor to see whether or not you should be treated with antibiotics.
If You Think You Have A Sinus Infection
If you feel you are experiencing sinus infection symptoms, make an appointment with your PartnerMD physician, and do not attempt to treat symptoms on your own. While you may initially be recommended OTC treatments, only your doctor can accurately diagnose your symptoms, and prescribe the right treatment for relief.
Have a question about your sinus infection symptoms? Contact us today to see if a relationship with a concierge doctor could be beneficial.
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Can Sinus Infections Lead To Ear Infections
Yes. A sinus infection can cause fluid to be trapped in the ear behind the eardrum. Bacteria and viruses can grow and can cause an ear infection. Its especially important to get to the doctor if youre feeling pain or pressure in the ear.
When you have a sinus issue, its important to understand that the nose and sinuses are a unit. This means you could be dealing with rhinosinusitis, which is inflammation of the nasal and sinus cavities. Sinusitis refers to an infection of the sinuses only.
There are many reasons why the nose and sinuses become inflamed it can be an anatomical issue or an infectious one. A former injury or birth defect, as well as sensitivities to allergens can cause some of the physiological impairments that lead to sinus issues.
Dont Rush To Antibiotics
The sinuses are small, hollow spaces inside the head. They drain into the nose. The sinuses often cause problems after a cold. They can also cause problems if they get blocked up from hay fever and other allergies. The medical name for sinus problems is sinusitis.
Sinus problems can be very uncomfortable. You may feel stuffed up. You may have yellow, green, or gray mucus. And you may feel pain or pressure around your eyes, cheeks, forehead, or teeth.
Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually do not need antibiotics. Heres why:
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Will Sinus Infections Resolve If Left Untreated
Lingering sinus infections should be treated before they escalate into a more serious issue. If a sinus infection is untreated, it may begin to impact the surrounding areas: the eyes and brain.
Untreated sinus infections can result in orbital and intracranial complications. Orbital refers to an infection that moves from the sinus into the eye. It can even result in an abscess in the eye area, which threatens vision.
Intracranial infections refer to infection in the brain. These can ultimately progress to become a brain abscess or meningitis if left untreated.
Because the sinuses are located close to the eye and brain, the most serious complications of an untreated sinus infection affect these important structures.
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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:
- 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
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Long Term Solutions For Chronic Sinusitis
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.
Cold Vs Viral Sinus Infection Vs Bacterial Sinus Infection
Many cold symptoms, flu symptoms, and sinus infection symptoms overlap with each other. To make matters more complicated, not all symptoms arent necessarily guaranteed. For example, even if you have a bacterial sinus infection, you may or may not have a fever, or you may or may not have a sore throat, etc.
However, its still worth knowing the differing symptoms between all these health issues, especially when it comes to fevers.
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How Long Do Antibiotics Take To Work On Sinus Infections
Often, sinus infections are treated with antibiotics. However, your doctor will determine the best treatment based on the root cause of your sinus infection. If antibiotics are prescribed, you may want to know how long it will be before you start to experience relief from symptoms.
Read on to find out how sinus infections are diagnosed, when your doctor may prescribe antibiotics, and how long it will take antibiotics to take effect.
Can Sinusitis Cause Death
Chronic sinusitis can spread to the eyes, blood, and brain, and, in rare circumstances, cause death. For that reason, its important to take instances of sinusitis that wont go away very seriously. If you have a persistent sinus infection, make sure you follow your doctors instructions regarding your antibiotics and of course, get plenty of rest.
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When To Use Antibiotics To Treat A Sinus Infection
Antibiotics only work against bacterial infections, so the best time to use them for a sinus infection is when you and your doctor suspect bacteria caused the infection.
Otherwise, you may be at risk for unwanted side effects or even antibiotic resistance.
When this happens, bacteria outsmart the medications designed to kill them, and the antibiotics no longer work when you need them.
That said, it can be hard to know whether a sinus infection is viral or bacterial.
Some scenarios, such as an infection that persists longer than 10 days or an infection that goes away and then returns, may indicate a bacterial infection and prompt a provider to prescribe antibiotics.
In some cases, a healthcare provider may also treat a sinus infection with antibiotics as a precaution to prevent complications in people with compromised immune systems that cant easily fight off infections.
If your doctor prescribes antibiotic treatment, follow their instructions.
Take the antibiotics at the same time every day. If you miss a dose, take it when you remember or, if its close to your next dose, wait until then and take one dose.
Do not double up on antibiotics doses.
If you experience unwanted side effects of antibiotics, your sinus infection isnt improving, or you develop new symptoms, contact your healthcare provider, who can help you figure out whats going on.
While sinus infections usually dont cause major medical problems, they can have severe symptoms and other complications.