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.
Do Antibiotics Benefit Any Subgroups
The investigators also analyzed the prognostic value of specific signs and symptoms to answer the question: Is there any subgroup of patients who might benefit more from antibiotic treatment?
Duration. Patients with a longer duration of symptoms, more severe symptoms, or increased age took longer to cure, but were no more likely to benefit from antibiotic treatment than other patients.
Symptoms, such as a previous common cold, pain on bending, unilateral facial pain, tooth pain, and purulent nasal discharge did not have any prognostic value.
Only one signpurulent discharge noted in the pharynx on examinationwas associated with a higher likelihood of benefit from treatment with antibiotics, but the NNT was still 8 in this group. Patients with symptoms for 7 days or longer were no more likely to respond to antibiotics than those with symptoms for fewer than 7 days.
Basics Of Doxycycline For Sinus Infection
According to a clinical trial published in the National Library of Medicine, doxycycline was far more effective than ampicillin in curing sinusitis in affected patients. 90% of the patients responded to the drug while only 35% responded to ampicillin. It was inferred that this is effective as it fights against the organisms as well as can penetrate the sinuses which act as a reservoir for the infections.
Doxycycline is an antibiotic that cures a wide variety of infections caused by different bacteria. Apart from sinusitis, it can also cure other bacterial infections including urinary tract infections, respiratory infections, eye infections, gonorrhea, syphilis, etc.
In addition to these infections, medicine is very effective in treating skin blemishes or acne. Moreover, it is believed that taking this drug also reduces the risk of malaria.
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Whats New: Realistic Evidence From Realistic Settings
We believe this meta-analysis provides a high level of evidence against routine treatment of sinusitis with antibiotics in primary care practice. Treating 15 patients with an antibiotic to possibly benefit 1 patient 2 weeks after treatment commences does not seem like a good idea when one considers the cost and complications of antibiotic use. Diarrhea and other adverse outcomes are 80% more common among patients with sinusitis who are treated with an antibiotic compared with placebo. As noted above, prior meta-analyses of antibiotic treatment for acute sinusitis have been more encouraging than this meta-analysis, with a number needed to treat of 7, but those meta-analyses are clearly overly optimistic for the results one will achieve in primary care practice using clinical signs and symptoms to diagnose acute sinusitis., Unlike the Young study, they included trials in specialty clinics with CT scans and sinus puncture and culture used for the diagnostic standard.
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.
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Signs And Symptoms Of Sinus Infection Or Sinusitis
Sinus Anatomy And Function
1. Benson V, Marano MA. Current estimates from the National Health Interview Survey, 1992. Vital Health Stat. 1994 189:1269….
2. McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA. 1995 273:2149.
3. Bamberger DM. Antimicrobial treatment of sinusitis. Semin Respir Infect. 1991 6:7784.
4. Dingle JH, Bodger GF, Jordan WS Jr. Illness in the home: a study of 25,000 illnesses in a group of Cleveland families. Cleveland Press: Case Western Reserve University, 1964:347.
5. Wald ER. Sinusitis in children. N Engl J Med. 1992 326:31923.
6. Hinriksdottir I, Melen I. Allergic rhinitis and upper respiratory tract infections. Acta Otolaryngol Suppl. 1994 515:302.
7. Gwaltney JM Jr, Scheld WM, Sande MA, Sydnor A. The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J Allergy Clin Immunol. 1992 90:45761.
8. Winther B, Gwaltney JM. Therapeutic approach to sinusitis: anti-infectious therapy as the baseline of management. Otolaryngol Head Neck Surg. 1990 103:8769.
9. Evans FO Jr, Sydnor JB, Moore WE, Moore GR, Manwaring JL, Brill AH, et al. Sinusitis of the maxillary antrum. N Engl J Med. 1975 293:7359.
10. Evans KL. Diagnosis and management of sinusitis. BMJ. 1994 309:141522.
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What Else Could Be Causing My Headache
Sinus headaches happen at the same time as a sinus infection. If a headache doesnt start with a sinus infection, or isnt going away as the sinus infection improves, it may be helpful to think about other types of headaches, such as:
Tension headaches: These are a common type of headache that also cause a pressure-like pain across the forehead. These are often caused by muscle tension in the facial and neck muscles.
Migraines: These headaches often cause a throbbing-like pain on one side of the head. Its common for people to have migraines when they have sinus infections as well, which can make it hard to know which type of headache it is.
Cluster headaches: These are a less common type of headache that start suddenly and usually cause a sharp pain around one of the eyes.
Dont hesitate to see a healthcare provider for severe headaches or headaches that arent going away, if you arent sure whats causing them.
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.
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How To Treat A Sinus Infection Without Antibiotics
Before you consider antibiotics, a sinus infection can be treated without leaving at home. Some of the home remedies to treat a sinus infection without antibiotics include:
Do Antibiotics Treat Sinus Infections
Antibiotics are a type of medication that stops bacteria from growing and, as a result, improves symptoms of an infection.
Healthcare providers only prescribe antibiotics for sinus infections that they believe are bacterial.
Antibiotics dont work on viral or fungal infections, and taking antibiotics when you dont need them can cause unnecessary side effects such as diarrhea, nausea, and stomach pain.
Plus, taking antibiotics too often can create antibiotic resistance.
The most common antibiotics prescribed for sinus infections are penicillin-class antibiotics such as amoxicillin or amoxicillin-clavulanate .
If you have a penicillin allergy, a common alternative is doxycycline.
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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
When Antibiotics Are Appropriate Treatment
In addition, antibiotics can be given to those whose symptoms have gotten worse or those who show no improvement after seven days.
If antibiotics are given, a 10- to 14-day course is recommended, according to the practice guidelines. Amoxicillin or amoxicillin clavulanate are typically the first choice for people who are not allergic to penicillin.
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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 JAMAin 2015 found that after saline irrigation, the second-best treatment for chronic sinusitis was a topical corticosteroid spray for a few days.
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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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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.
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Treating Chronic Sinusitis: Use Of Iv Antibiotics
Chronic sinusitis infections are commonly known to be of a polymicrobial nature. A single oral agent usually does not have the capability of covering all the organisms involved in chronic sinusitis. In addition, oral agents may fail due to less than optimal concentration of medications that can be achieved in the bloodstream. This mainly happens because of . Decreased absorption can occur because of the co-administration of other oral agents, interaction with certain food and drink groups and illness.
The reduced concentration of medicine via oral agents has difficulty attacking the infection when located in the bone surrounding the sinus cavities. Intravenous antibiotics can overcome many of the drawbacks involving oral agents. The concentration of antibiotic in many cases is more stable. The antibiotic is not affected by variables in the gastrointestinal tract because it bypasses and directly enters the bloodstream.
Absorption problems are minimized. Since some of the infection is in the surrounding bone a higher concentration of medicine is necessary. Intravenous induction will increase the concentration and can be sustained over longer periods of time. The use of multiple antibiotics at the same time helps to insure a broader spectrum of action, thus attacking many forms of bacterial infections simultaneously.
Why Are Antibiotics Important
Antibiotics are one of the most common classifications of drugs used to treat bacterial infections. Since their introduction to the world of medicine, they have helped treat countless people, especially those with infectious diseases.
Antibiotics are very crucial during surgeries and are used to prevent patients from getting any infections from the cut. Without antibiotics, there is a higher chance of blood poisoning and the more complicated surgeries would not be possible to perform.
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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.
What Home Remedies Help Soothe Sinus Infection Or Sinusitis Symptoms
Sinus infections caused by viruses can use home treatments such as pain and fever medications , decongestants, and mucolytics. In addition, some health care professionals suggest nasal irrigation or a sinus rinse solution to help relieve symptoms of sinus infections, even chronic sinusitis symptoms. This irrigation is accomplished with a Neti-Pot or a sinus rinse kit . The last reference of this article shows a video of a sinus rinse procedure. In 2012, the FDA issued a warning about the use of Neti-Pots. The FDA cautions people not to use untreated tap water for rinsing, as contaminated tap water rinses lead to two deaths.
Bacterial and fungal sinus infections usually require antibiotic or antifungal therapy so home treatments without them are often not successful. However, some authors suggest home treatments may reduce symptoms after medical therapy has begun some healthcare professionals recommend nasal irrigation after sinus surgery.
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