Antibiotics for Sinusitis

October 17, 2020

Should You Treat Sinusitis with Antibiotics?

You might think that antibiotics are what you need for treating sinusitis, inflammation of the sinuses, but, unless there is bacterial growth, that would not be helpful, and could actually prove to be harmful. Inflammation can be caused by pollen or dust, with or without a microorganism causing infection. Early sinus infections are a type of sinusitis caused by viruses, which, being only a few genes protected by protein, are too simple to be affected by antibiotics.

We all have bacteria in our systems, and if they are exposed to, for example, penicillin, they can evolve resistance to it. Then if those penicillin-resistant bacteria become overgrown and create infection, we will have to be treated with newer, more expensive antibiotics. This keeps the pharmaceutical firms rushing to invent ever newer drugs that the bacteria have not been exposed to yet. Antibiotic-resistant strains of bacteria can spread throughout the community and become a public health hazard.

In early sinusitis, it is very rarely a bacterial cause. If a sinus infection lasts longer than 10 days, your physician might suspect that bacteria landing on all that mucus have decided to come to the party and start growing. In that case antibiotics could be prescribed, but let’s not let things get that far:

Treatments of Acute Sinusitis

Saline irrigation
is salt water that can be sprayed or gently poured into the nose. This will remove pollen, dust, other irritants, and viruses.

Over-the-counter corticosteroid nasal sprays for lowering inflammation are available in weak strengths. More concentrated versions are available by prescription. Some prescription-strength corticosteroid nasal sprays are:

Beconase or Vancenase–(beclomethasone nasal) usual dose, one to two inhalations into each nostril twice a day

Dymista–(azelastine hydrochloride) recommended dose, one inhalation into each nostril once a day

Nasarel–(flunisolide) recommended dose, two sprays into each nostril twice a day

Nasonex–(mometasone furoate monohydrate) recommended dose, two sprays into each nostril, twice daily

Qnasl–(beclomethasone dipropionate) usual dose, two sprays into each nostril daily

Veramyst–(fluticasone furoate) usual dose, two sprays into each nostril once a day

Zetonna–(ciclesonide) usual dose, one spray per nostril, once a day

Psuedoephedrine—a decongestant that can help to decrease the swelling of the mucus membranes

Antihistamines—if the cause are allergies, antihistamines may be the way to go for sinusitis

Corticosteroids (Prednisone or Dexamethasone)—in bad cases this may help significantly decrease the swelling of the mucus membrane


Antibiotics for Acute Sinusitis (If Symptoms >10 days)

–500 mg orally three times daily or 875 mg orally twice daily

Augmentin–500 mg/125 mg orally three times daily or 875 mg/125 mg orally twice daily

Doxycycline–100 mg orally twice daily or 200 mg orally daily (for patients with penicillin allergies)

Levofloxacin–750 mg or 500 mg orally once daily

If you had symptoms for more than 10 days, consider talking to your doctor regarding possible antibiotic therapy. Our QuickMD doctors can help you and prescribe you antibiotics online for sinusitis–if the duration has been longer than 10 days.

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