Thursday, June 16, 2022

When To Treat A Sinus Infection With Antibiotics

How An Ent Treats A Sinus Infection

Sinus Infections Shouldn’t be Treated with Antibiotic

If you have a lingering sinus infection after antibiotics, an ENT doctor often elects to be more aggressive in treatment than a primary care physician. They may prescribe longer courses of antibiotics, stronger medications, or recommend a procedure to open the sinuses.

If you have persistent sinus problems, the sinuses must first be unblocked. Sometimes, thats done through a simple balloon sinuplasty and irrigation. Other times, unblocking the sinuses requires a more aggressive procedure like endoscopic sinus surgery. We opt for this procedure when the sinuses become so blocked, tissue and bone need to be removed to create a wider opening.

If youre dealing with a lingering sinus infection, dont let it progress to a more serious issue. Call your ENT so they can discover whats at the root of your problem and find a treatment to bring you relief.

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

Untreated Sinus Infection Risks

Sinus infections often start to improve on their own after about 10 days. If your symptoms last longer without improving or if they worsen, a doctor may need to treat the underlying cause of the infection.

If a sinus infection affects a sinus cavity close to the brain, it can spread to the brain if left untreated. Though rare, an infection can also pass into the eye socket and cause vision changes or blindness. These types of infections are more common in kids.

While uncommon, a serious fungal sinus infection left untreated may pass into the bones.

Make an appointment with a doctor if you have severe symptoms, or if the following symptoms last longer than 10 days or keep coming back:

  • fever
  • congestion
  • facial pain

Because the cause of your sinus infection can affect your treatment options, its important to see a doctor for a diagnosis. The Healthline FindCare tool can provide options in your area if youre looking for a doctor.

If you believe you have chronic or recurring sinusitis, consider asking for a referral to an otolaryngologist, also known as an ear, nose, and throat specialist. You may need imaging and other tests to determine the cause of your symptoms.

An ENT specialist can take a culture of nose drainage to better understand the cause of an infection. The ENT specialist can also examine the sinuses more closely and look for any problem in the structure of the nasal passages that could lead to chronic sinus problems.

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Caveats: Refer Seriously Ill Patients And Complicated Cases

A very important caveat to our recommendation is that seriously ill patients must be managed differently. Very infrequently a patient develops a serious complication of acute sinusitis such as brain abscess, periorbital cellulitis, or meningitis. Therefore, seriously ill patients with signs and symptoms of acute bacterial sinusitis, such as high fever, periorbital erythema or edema, severe headache, or intense facial pain must be carefully evaluated and treated with great caution and close follow-up. These patients should be referred immediately for consultation with an otolaryngologist.

Lingering Sinus Infection Or Chronic Runny Nose

Top 8 Sinus Infection Natural Remedies

A lingering sinus infection is different from a chronic runny nose. Chronic runny nose typically comes from allergies or other irritants in the air. However, this can turn into an infection over time.

When the sinuses become infected, the allergies, irritants, or viral cold have caused swelling in the nose thats blocked the drainage pathways. Consequently, fluid and mucous accumulate in the sinuses, where it has become infected with bacteria.

If youve been sick more than 10 days and begin to experience other symptoms like facial pressure, headache, and fever, youre dealing with more than a chronic runny nose.

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Is My Sinus Infection Immune To Antibiotics

Patients who get recurring sinus infections have real concerns about using so many antibiotics. They are not only concerned about the side effects and the cost but also the risk that these important medicines will no longer be effective. Its not actually the patient that becomes immune but the particular bacteria.

Grapefruit Seed Extract For Treating Digestive Issues

Grapefruit seed extract can help treating H. pylori infection. Helicobacter Pylori is bacteria that may aggressively attack the lining of the stomach. Some of the symptoms of H. pylori infection are stomach ulcers, pain, and general digestive upset. There are other proven natural remedies that can help treat Helicobacter Pylori infection.

Grapefruit seed extract can help to protect your stomach from damage caused by stress and alcohol consumption.

A study found that grapefruit seed extract was effective in treating intestinal infections caused by Candida, Geotrichum sp and hemolytic E. Coli. The participants in the study who received the GSE had a definite improvement in digestive issues such as constipation, flatulence, and abdominal discomfort.

There are no exact guidelines on how much GSE you need to use in order to improve your digestive health. However in the last study I mentioned, participants consumed 2 drops of grapefruit seed extract mixed with 200 mL water twice daily for one month.

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First Line Of Defense Against Sinusitis: Nasal Irrigation

One of the simplest, cheapest, and most effective ways to prevent and treat sinus problems is nasal irrigation. Using a homemade solution, you can often relieve sinusitis symptoms, reduce reliance on nasal sprays and antibiotics, and improve your quality of life. At least once a day, follow these steps:

  • Stir ½ teaspoon of non-iodized salt and ½ teaspoon of baking soda into 2 cups of lukewarm distilled or previously boiled water .
  • Fill a small bulb syringe with the saltwater solution.
  • Lean over your bathroom or kitchen sink, insert the tip of the syringe just inside one nostril, and gently squeeze the bulb. The water will run back out the nostril and into the sink. Use at least one full bulb of solution.
  • Repeat the procedure in the other nostril.
  • Thoroughly rinse and dry the bulb syringe or neti pot after each use.
  • What Are The Six Types Of Sinusitis And Sinus Infections

    Do antibiotics really help in managment of Sinus Infection? – Dr. Harihara Murthy

    Sinusitis may be classified in several ways, based on its duration and the type of inflammation . The term rhinosinusitis is used to imply that both the nose and sinuses are involved and is becoming the preferred term over sinusitis.

    • Acute sinus infection usually lasts less than 3-5 days.
    • Subacute sinus infection lasts one to three months.
    • Chronic sinus infection is greater than three months. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.
    • Recurrent sinusitis has several sinusitis attacks every year.

    There is no medical consensus on the above time periods.

    • Infected sinusitis usually is caused by an uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of a sinus infection usually are the result of incomplete treatment of an acute sinus infection.
    • Noninfectious sinusitis is caused by irritants and allergic conditions and follows the same general timeline for acute, subacute, and chronic as infectious sinusitis.

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    Sinus Infection Treatment In Children

    Sinus infections affect children similarly.

    If your child has a sinus infection, the aforementioned home remedies may help, but make sure to follow your pediatricians recommendations to treat your childs illness.

    Note that various over-the-counter medications may not be suitable for your child:

    • Babies 6 months old or younger should only receive acetaminophen for pain relief
    • Children older than 6 months can receive acetaminophen or ibuprofen
    • Children should never receive aspirin and teenagers recovering from chicken pox or flu-like symptoms should not take aspirin because of the risk of a rare and severe illness called Reyeâs syndrome

    Children younger than 4 years should not receive cough or cold products unless directed by a pediatrician .

    Which Antibiotics Are Most Effective For Bacterial Sinusitis

    Antibiotics are indicated for sinusitis that is thought to be bacterial, including sinusitis that is severe or involves the frontal, ethmoid, or sphenoid sinuses, since this type of sinusitis is more prone to complications. Penicillins, cephalosporins, and macrolides seem to be equally efficacious. A 5- to 10-day regimen of amoxicillin 500 mg 3 times a day is recommended as first-line therapy.

    One study suggests that a single dose of 2 g of extended-release azithromycin may be more effective than a 10-day course of amoxicillin/clavulanate. However, azithromycin is not likely a good choice in sinusitis because symptoms may improve only because of the anti-inflammatory efficacy of the agent and because it has poor efficacy against S pneumoniae and H influenzae. The risk of adverse effects should be weighed against the severity of disease and patient comorbidities prior to initiating antibiotic treatment.

    Patterns of bacterial resistance should also be taken into account in the choice of antibiotic.

    References
  • Lucas JW, Schiller JS, Benson V. Summary health statistics for U.S. adults: National Health Interview Survey, 2001. Vital Health Stat 10. 2004 Jan. 1-134. .

  • Slavin RG, Spector SL, Bernstein IL, Kaliner MA, Kennedy DW, Virant FS, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005 Dec. 116:S13-47. . .

  • Lusk RP, Stankiewicz JA. Pediatric rhinosinusitis. Otolaryngol Head Neck Surg. 1997 Sep. 117:S53-7. .

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    Two Types Of Sinus Infections

    Lets differentiate between acute and chronic sinus infections. Acute sinus infections can last up to 4 weeks. If you are experiencing sinus infection symptoms for longer than 2 weeks, it doesnt mean you have a bad case of sinusitis this is normal. If you experience symptoms for longer than 4 weeks, this can be considered subacute anything that lasts longer than 12 weeks is considered chronic.

    Now, lets differentiate between bacteria and viruses. Either of the two can infect the body, and each warrants a different course of treatment. Bacterial infections require antibiotics, while viral infections do not they resolve themselves. All you can do in the latter case is to drink plenty of fluids, rest, and take decongestants. The majority of cases are viral, in which case your doctor cant prescribe you with anything other than decongestants.

    Sinus Infection Definition And Facts

    Antibiotics for sinus infection
    • 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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    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.

    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:

  • Use saline spray two to three times per day in each nostril.
  • Use a nasal decongestant such as Afrin®, but not longer than three days.
  • Drink eight 8-ounce glasses of fluid per day.
  • Get plenty of rest.
  • Take an over-the-counter anti-inflammatory, such as acetaminophen or ibuprofen to help relieve the swelling of your sinuses.
  • 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.

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    Treating Sinus Infections Without Antibiotics

    Tomah, WI – People often want antibiotics to tackle a sinus infection but that might not be the best treatment since most infections are caused by viruses. Antibiotics fight bacteria, not viruses.

    There are also complications that can develop with dependency on these drugs. The more antibiotics are used the less effective they can become, with possible side effects like dizziness, stomach problems and rashes.

    Instead of turning to antibiotics, Alan Conway, M.D., family physician at Mayo Clinic Health System Franciscan Healthcare in Tomah, suggests some alternative methods of treatment. Dr. Conway says, First of all, you should give yourself enough rest. Your body needs the time to fight the infection with full force, especially in the first few days when symptoms are the most severe.

    Dr. Conway also says. Watch out for over-the-counter products that contain oxymetazoline. These products may relieve symptoms for a few days, but they can cause congestion if used longer than three days. Instead, use generic pseudoephedrine pills if you are stuffed up for more than three days.

    Sinus infections can turn into a bacterial infection, due to the prolonged blockage in the sinus cavity. It is not easy to determine whether the infection is viral or bacterial, considering that the symptoms are the same for both. Even if the infection becomes bacterial, 70% of the time the infection will go away within two weeks without antibiotics.

    # # #

    What Is Sinus Infection And How Does One Get Infected

    Do Antibiotics Help With Sinus Infections?

    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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    What To Do For Chronic Sinusitis

    If youre suffering from chronic sinusitis or you are getting frequent sinus infections you should see your doctor, says Dr. Sindwani.

    Your doctor will swab your nose to collect mucus. Culturing it in a laboratory will reveal which type of bacteria is causing the infection so the right antibiotic can be prescribed.

    Treat early sinus infection symptoms with rest, hydration and over-the-counter sprays and decongestants. But dont look for an antibiotic unless your illness extends beyond a week, he says. Then check in with your doctor for a prescription and let him or her know if your condition worsens.

    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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