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.
What Causes A Sinus Infection
In most cases, acute sinusitis is caused by a bacterial or viral infection, which means it usually develops after youve had a cold or the flu. Its possible for an acute sinus infection to develop into a chronic infection over time. However, most chronic sinus infections are caused by:
- Problems with the physical structure of your sinuses such as nasal polyps, narrow sinuses, or a deviated septum
- Allergies such as hay fever that cause inflammation
Certain health conditions are also known to accompany chronic sinusitis. These include:
- Primary immune deficiency disesase
Symptoms > 1 Week Are Not A Reason To Prescribe
One very important new finding in this meta-analysis that should change practice is that the duration of illness did not predict a positive response to antibiotics.
Current national recommendations are to use an antibiotic for patients with a duration of illness longer than 1 week, as these patients are presumably more likely to have a bacterial infection.- However, that recommendation had been based on expert opinion, not on data from clinical trials. A longer duration of symptoms should not be a reason to prescribe an antibiotic for sinusitis symptoms.
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How You Can Treat Sinusitis Yourself
You can often treat mild sinusitis without seeing a GP by:
- getting plenty of rest
- taking painkillers, such as paracetamol or ibuprofen
- avoiding allergic triggers and not smoking
- cleaning your nose with a salt water solution to ease congestion
You do not need to use all of the solution, but make a fresh solution each time you clean your nose.
What Is The Safest Antibiotic For Sinus Infection
Most cases of sinusitis clear up within 10 days. Antibiotics are not needed for acute viral sinusitis. If a secondary bacterial infection should develop, one treatment of choice is amoxicillin-clavulanate . In patients who have severe allergy to penicillin-type drugs, doxycycline is a reasonable alternative.
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Related Resources For Sinus Infections
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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
Should You Stay Home With Sinus Infection
Sinus infections can be viral or bacterial. Either way, its best to stay home, Wigmore says. Viral sinus infections are often contagious. If you have had symptoms longer than one week, or if you have severe facial pain, teeth/jaw pain, or fever, you may have a bacterial infection and should consult your doctor.
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Related Conditions And Risk Factors
Sinusitis is a type of upper respiratory infection. Upper respiratory infections are infections that occur in your upper respiratory tract, which consists of your nose, sinuses, and throat. The common cold is a type of URI. Others types of URIs, besides the common cold, include:
- Laryngitis: Inflammation of the larynx, which is an organ that contains our vocal cords.
- Pharyngitis: Inflammation of the pharynx, which is the part of the throat behind your nose and mouth.
If left untreated, there can be rare but serious complications. A sinus infection can spread to the eyes, causing a range of symptoms ranging from swelling to blindness. Infectious sinusitis can also, uncommonly, lead to meningitis, the inflammation of the membranes surrounding the brain and spinal cord, or osteomyelitis, an infection to the bones of the skull.
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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.
Symptoms And Treatment For Viral Vs Bacterial Sinusitis
Weve all experienced the common cold symptoms of a runny nose, nasal congestion, and sinus pressure. But sometimes these symptoms can indicate something different: sinusitis, or a sinus infection. Sinusitis can be viral or bacterial. Knowing which one you have can be helpful for treating sinus infection symptoms and helping ensure you feel better fast.
In this article, I will describe the symptoms of both viral and bacterial sinusitis. I will also talk about the causes of each, how theyre diagnosed, and what your treatment options are.
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Symptoms And Signs Of Sinusitis
Acute and chronic sinusitis cause similar symptoms and signs, including purulent rhinorrhea, pressure and pain in the face, nasal congestion and obstruction, hyposmia, halitosis, and productive cough . Often the pain is more severe in acute sinusitis. The area over the affected sinus may be tender, swollen, and erythematous.
Maxillary sinusitis causes pain in the maxillary area, toothache, and frontal headache.
Frontal sinusitis causes pain in the frontal area and frontal headache.
Ethmoid sinusitis causes pain behind and between the eyes, a frontal headache often described as splitting, periorbital cellulitis, and tearing.
Sphenoid sinusitis causes less well localized pain referred to the frontal or occipital area.
Malaise may be present. Fever and chills suggest an extension of the infection beyond the sinuses.
The nasal mucous membrane is red and turgescent yellow or green purulent rhinorrhea may be present. Seropurulent or mucopurulent exudate may be seen in the middle meatus with maxillary, anterior ethmoid, or frontal sinusitis and in the area medial to the middle turbinate with posterior ethmoid or sphenoid sinusitis.
Manifestations of complications include periorbital swelling and redness, proptosis, ophthalmoplegia, confusion or decreased level of consciousness, and severe headache.
What Is Sinus Infection And How Does One Get Infected
Sinus cavities are empty spaces in which the air flows it is located within the bones that surround our nose. When our nasal cavities become swollen, an infection may immediately follow, particularly because the sinuses were filled with germs and fluid that block the passages, which is the main reason for infection.
Depending on the type of infection your sinus has acquired, it could last longer than you wish it would. Acute sinusitis may last for about a couple of week even when you are self-medicating. Bacterial sinusitis, those which doctors usually recommend antibiotics to cure, occur if the symptoms last for over 14 days. Nevertheless, you may be surprised at how long chronic sinusitis could last it can constantly give you trouble up to 12 weeks, especially those that are associated with certain allergies. Sinus infection can affect anyone from all the age brackets.
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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.
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.
Therefore, allergists and other specialists recommend limiting the use of antibiotics unless:
- Symptoms last over seven to 10 days
- Specific symptoms are present
- A fever is present
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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 Treatment Options
There are many treatment options for a sinus infection, but the best treatment option varies by the severity of the case. Some acute sinus infections will clear up on their own without any treatment, and you may just think it was a cold. Others require more serious interventions by a healthcare provider.
The standard treatment healthcare providers prescribe for a presumed bacterial sinus infection is an antibiotic. However, if you have a sinus infection caused by a viral infection such as the common cold, your doctor will not prescribe antibiotics as these medications only treat bacterial infections. Instead, you can treat the sinus infection symptomatically until it resolves, with nasal decongestants and antihistamines.
There are plenty of ways to treat symptoms of a sinus infection at home with over-the-counter medications and home remedies. OTC antihistamines block the effects of histamine, helping symptoms like sneezing and runny nose. Simple treatments like drinking water, keeping your sinuses hydrated , and using warm compresses, can also help treat symptoms of a sinus infection.
Keeping your nasal passages clean can help you prevent future sinus infections. If you anticipate having sinus issues during allergy or cold season, flushing out your nasal passages with a saltwater solution can help you avoid the pains of a sinus infection.
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What Is The Best Medication For A Sinus Infection
The best medication for sinus infection treatment is determined by your doctor and varies by case. Below, you can see a comparison of the most common sinus infection medications to learn what to expect.
|Best medications for sinus infections|
|Expectorant||Oral||1, 1200 mg tablet every 12 hours no more than 2 tablets in 24 hours do not chew or crush. Take with a full glass of water.||Headache, nausea, dizziness, drowsiness|
Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
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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Get The Best Antibiotics For Sinusitis Infection
Antibiotics are used to medicate sinus infections, whether acute or chronic sinusitis. The difference is in the dosage. Since acute sinus infections inflict a person for a short period of time only, the antibiotic dosage is commonly just one round of seven days. Dosage for chronic infections may take several weeks, and is likely to repeat throughout the year.
While you can get some antibiotics over the counter, it is best to get checked up by your doctor first and get a prescription.
A survey conducted on the usage of the antibiotics for sinusitis shows that many take antibiotics from the penicillin family. Macrolides and cephalosporins come next.
If the number of users is an indication, then Amoxicillin is probably the best antibiotics for sinus infection. It belongs to the penicillin family.
Amoxicillin works by affecting the metabolism of bacteria. It slows it down, alongside increasing the production of your bodys enzymes. Eventually, the bacteria weakens and is killed off.
Studies peg the effectiveness of Amoxillin in curing sinus infections at almost 89%. This is for acute sinusitis only. Chronic ones may experience different levels of effectiveness.
Amoxicillin should be taken every 8 hours or 12 hours, at 250 milligrams or 500 milligrams respectively. Children are given less dosage, depending on their weight and age.
The drug is available in tablet, liquid and chewable tablet forms. It doesnt matter if youve eaten when you take it.
Most Sinus Infections Dont Require Antibiotics
Ah, . The New England Journal of Medicine published a clinical practice review of acute sinus infections in adults, that is, sinus infections of up to four weeks. The need for an updated review was likely spurred by the disconcerting fact that while the vast majority of acute sinus infections will improve or even clear on their own without antibiotics within one to two weeks, most end up being treated with antibiotics.
It is this discrepancy that has clinical researchers and public health folks jumping up and down in alarm, because more unnecessary prescriptions for antibiotics mean more side effects and higher bacterial resistance rates. But on the other hand, while 85% of sinus infections improve or clear on their own, theres the 15% that do not. Potential complications are rare, but serious, and include brain infections, even abscesses.