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)
Amoxicillin–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.