Most Sinus Infections Dont Require Antibiotics
Ah, sinus infections. 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.
Sinus Infection Home Remedies And Prevention
Along with treatment, specific home remedies can help you improve faster and keep the symptoms at a tolerable level for the duration that the sinus infection exists. Also, you can even give yourself a better chance to prevent obtaining an acute sinus infection altogether with proper lifestyle changes in place.
For home remedies, rest and eating healthy is the best way to recover promptly. When the body is fighting off a sinus infection, or any infection for that matter, it needs proper rest and nutrients to do so. With that said, there are several quick, easy things to do while you rest, such as:
- Clean out your nasal passageway
- Elevate your head while sleeping
- Place a humidifier in your home
- Take hot showers
Ultimately, it comes down to the focus on relieving the pressure built up in your sinuses. The best way to do that is to keep your nasal passageway from getting clogged. Using a warm compress, placing a humidifier in your home and elevating your head while resting is all excellent tactic to implement to keep the nasal passageway clear and breathing easily.
So how do you prevent a sinus infection from occurring in the first place? While it is not always possible to avoid, there are precautions you can take to help minimize your risk, including:
- Receiving a flu shot
- Keeping your distance from others who are sick
- Planning for an allergy attack
- Practice good hygiene
What Are The Symptoms Of Pediatric Sinusitis
The following symptoms may indicate a sinus infection in your child:
- A cold lasting more than 10 to 14 days
- Low- or even high-grade fever
- Thick yellow-green nasal drainage for at least three days in a row
- Post-nasal drip, sometimes with sore throat, cough, bad breath, nausea and/or vomiting
- Headache, usually in children age six or older
- Irritability or fatigue
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What You Need To Know About Sinus Infections
As the fall months approach, the potential for seasonal allergies, runny noses and sinus infections increases.
Sinus infections happen when fluid builds up in the air-filled pockets in the face. This allows germs to grow. Viruses cause most sinus infections, but bacteria can also be the culprit.
When people say they have sinus pressure, they may mean nasal congestion, Grayson said. Bilateral congestion could mean a person has a viral infection or an allergic reaction. Viral infections dont pick and choose a side.
Grayson adds that people who live in more humid climates like the South tend to suffer more from seasonal allergies because the humidity allows more fungus to grow, and long growing seasons allow for other trees, grasses and weeds. Living in cities can also affect people with allergies due to dust mites.
If your sinus pressure is isolated, you might have a bacterial infection, she said. Thats when you really should go see a doctor. With a virus, you just have to let it run its course.
Some people do get repetitive events, and people who work with small children, such as teachers or day care workers, are more likely to get recurrent viral infections.
Jessica Grayson, M.D.That pesky flu
Viral Vs Bacterial Sinus Infection
Viral Sinus Infection
Aside from causing common cold, viruses can cause inflammation in the sinuses. Symptoms like a runny nose and nasal congestion are some of the hallmarks of viruses which can further lead to inflammation of the sinuses. The discomfort from the illness reaches its peak usually on the fourth or fifth day and slowly begins to recede afterwards. It can take anywhere from a week to ten days for the above mentioned nasal symptoms to go away on their own. Improvement in patients with common cold can be seen after that, yet it might take them more time to return to normal.
Bacterial Sinus Infection
Bacterial sinus infection or bacterial sinusitis occurs when drainage of the fluid collected within the sinuses is hampered somehow. This is often observed in common cold which causes an overload of the fluid in the sinuses. Bacteria tend to thrive in the sinus pockets that are wet, moist and filled with fluid. The bacterial growth usually occurs after 10-day duration of the common cold.
Doctors are not able to differentiate between viral or bacterial sinusitis since the diagnosis for both of them is to check the symptoms like nasal congestion, headache, cough, thick post-nasal or nasal drainage, etc. In some cases, the help of other diagnostic tests like cultures or CT scans is taken to reach a definitive diagnosis.
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Treatments For A Sinus Infection
At-home, natural treatments like nasal irrigation may be the first thing on your mind when you think of treatments for a sinus infection.
However, natural remedies may not cut it at times. If natural treatments for sinus infections dont work, your medical provider might recommend medications like antibiotics or decongestants.
Your doctor might recommend one or a combination of the following medications to help decrease inflammation in the nose and sinuses, reduce pain and improve sinus drainage.
Common medications include:
Many sinus infection home care remedies are still effective. Some simple suggestions for treating your sinus infection are:
- A nasal rinse or wash
- A cold compress on or around your eyes and forehead
- Using a humidifier at night
- Drinking plenty of water
Some providers may recommend alternative therapies for sinus infections, like nutritional supplements, herbs, or acupuncture. There are risks to any treatment methods, however, and you should always consult with a specialist before beginning any treatment plan for your sinus infections.
- Gastrointestinal issues like sensitive stomach, diarrhea, or ulcers. Antibiotics are also common triggers for these issues.
Risks of sinus surgery
How Do You Get Rid Of A Sinus Infection Fast
You can treat a sinus infection at home or with OTC medications for symptom relief, and/or a prescription antibiotic medication, in the case of a bacterial infection. Stay hydrated, use a humidifier, and sleep at an incline to help resolve your sinus infection quickly. Consult your healthcare provider to see if you need an antibiotic.
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How Can I Avoid Future Sinus Infections
Once youve had a nasty sinus infection, you wont want to relive the experience. To help prevent them from occurring again, get your annual flu shot and steer clear of people with colds or the flu. Use your humidifier. Live as healthfully as you can get sufficient sleep, reduce stress and eat a wholesome diet with plenty of whole grains, lean proteins and fruits and vegetables. Avoid exposure to secondhand smoke and if you do smoke, take steps to quit. Last, but not least, always wash your hands.
Ultimately, sinusitis is a painful and revolting nuisance. But approaching them with these smart strategies could save you a world of hurt.
When To See Your Doctor
A sinus infection can resolve itself with home treatment. But there are times when you should see a doctor.
Make an appointment with your doctor if your symptoms dont improve with OTC medications or home remedies, or if your symptoms worsen.
Contact your doctor if you have a fever higher than 101°F , or if you start coughing up green or yellow mucus. Also see your doctor if you have recurrent sinus infections.
Leaving a severe sinus infection untreated increases the risk of complications, such as meningitis. Meningitis is inflammation of the membranes in the brain or spinal cord.
An untreated infection can spread to other parts of the body, such as the bones, eyes, and skin. It can also affect your sense of smell.
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Functional Endoscopic Sinus Surgery
Functional endoscopic sinus surgery or FESS is another approach your doctor may recommend to treat chronic sinusitis.
An ear, nose, and throat surgeon will use a special tool with a lighted camera on the end to visualize the inside of your nose.
They will then use small instruments to remove excess tissue, nasal polyps, or nasal cysts to widen your sinuses.
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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When Antibiotics Are Needed
Historically, sinus infections, also called sinusitis, were often treated with antibiotics. But today, many allergists warn against the random use of antibiotics for a sinus infection.
Antibiotics can help eliminate bacterial sinus infections. But when a sinus infection is caused by allergies, a virus, or other causes such as a structural defect of the sinuses, an antibiotic will not help to alleviate symptoms.
The overuse of antibiotics is when they are prescribed for reasons other than when they are needed. Because of the common overprescribing of antibiotics for the type of sinus infections that do not warrant such treatment, many people have developed whats commonly referred to as antibiotic resistance.
Types Of Sinus Infections: Chronic Vs Acute
There are four types of sinus infections. These classifications depend on the length and frequency of the infection:
- Acute sinusitis.This type of sinus infection lasts only for a short time, defined by the American Academy of Otolaryngology as less than 4 weeks. This short-term infection is usually part of a cold or other respiratory illness. It may also be caused by a bacterial infection .
- Subacute sinusitis. A subacute sinus infection lasts between 4 and 12 weeks .
- Recurrent acute sinusitis. An acute sinus infection is considered recurrent if the infection returns four or more times within a year, with each infection lasting 7 days or more.
- Chronic sinusitis.Chronic sinus infections last for more than 12 weeks or continue to recur.
Many sinus infection symptoms are common in both acute and chronic forms. Seeing a doctor is the best way to learn if you have an infection, find the cause, and get treatment.
For cases of acute bacterial sinus infections, these symptoms last at least 10 days without improving, or they worsen within 10 days after seeming to improve. In this case, its important to talk with a doctor, such as a general practitioner or an ear, nose, and throat doctor , to get a diagnosis and treatment plan.
Learn more about the symptoms of a sinus infection below.
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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.
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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How To Treat Sinus Infections With Surgery
When other treatment methods fail, the final resort for sinusitis is surgery. In many cases, the goal is to fix defects in the sinuses. Reasons to undergo surgical treatment for sinusitis include:
- Narrowing of the sinuses caused by other reasons
- Presence of nasal polyps growths that block the sinuses and increase the risk of infection
- Recurrent sinus infections
- Small sinus drainage openings from birth
Sinus Surgery For Chronic Infections
If medical therapies dont clear up chronic sinusitis, your doctor will usually recommend surgery.
Several surgical approaches can enlarge the sinus cavities to make breathing and drainage easier. In the past, sinus surgeries required bone and tissue removal. Recent advancements mean this isnt the case.
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Causes & Risk Factors
Any health situation that blocks off the vital drainage channels of your sinuses can cause a sinus infection including:
- Respiratory infections like the common cold
- Hay fever or exposure to allergens such as cigarette smoke, dry air and pollutants
- Obstructions in the nasal or sinus cavities including nasal polyps, deviated septum, or nasal bone spur
- Non-allergic rhinitis
- Changes in air pressure
- Infections resulting from dental problems
- Physical injury to the sinuses
- Bacteria, viruses, and fungi
The five most common bacteria that can cause sinus infections are: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Streptococcus pyogenes.
Risk factors for sinus infections include:
- Being in the hospital, especially if the reason you are in the hospital is related to a head injury or you needed a tube inserted into your nose
Treatment For Sinus Infection
Whether you have an acute sinus infection or a chronic infection, a number of treatment options can relieve your discomfort. If youre in the early stage of an acute sinus infection, it may be appropriate to start at-home treatments while you monitor your symptoms. If your sinusitis worsens, youll need to call your doctor for medication and further care. Even if youre receiving treatment from your doctor, at-home care can help ease your symptoms.
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Will I Need To Make Lifestyle Changes To Deal With Sinus Infections
If you have indoor allergies it is recommended that you avoid triggersanimal dander and dust mites, for exampleas well as take medications. Smoking is never recommended, but if you do smoke, strongly consider a program to help you quit. Smoke can also trigger allergies and prevent removal of mucous by the nose. No special diet is required, but drinking extra fluids helps to thin nasal secretions.