Sinus Infection (Sinusitis)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideSinus Infection (Sinusitis) Symptoms & Treatment

Sinus Infection (Sinusitis) Symptoms & Treatment

Are antibiotics necessary to treat sinus infections and sinusitis?

For sinusitis caused by virus infection, no antibiotic treatment is required. Frequently recommended treatments include pain and fever medications (such as acetaminophen [Tylenol]), decongestants and mucolytics (medication that dissolve or breakdown mucous, for example, guaifenesin.

Bacterial infection of the sinuses is suspected when facial pain, nasal discharge resembling pus, and symptoms persist for longer than a week and are not responding to OTC nasal medications. Acute sinus infection from bacteria is usually treated with antibiotic therapy aimed at treating the most common bacteria known to cause sinus infection, since it is unusual to be able to get a reliable culture without aspirating the sinuses.

The five most common bacteria causing sinus infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Streptococcus pyogenes. The antibiotics that are effective treatment for sinus infection must be able to kill these bacterial types. Although amoxicillin (Amoxil) is an acceptable first antibiotic for an uncomplicated acute sinus infection, many physicians choose amoxicillin-clavulanate (Augmentin) as the first-line drug for treatment of a suspected bacterial sinus infection because it is usually effective against most of the species and strains of bacteria that cause the disease.

In the penicillin allergic individual, cefaclor (Ceclor), loracarbef (Lorabid), clarithromycin (Biaxin), azithromycin (Zithkromax), sulfamethoxazole (Gantanol), trimethoprim (Bactrim, Septra) ciprofloxin (Cipro), and other antibiotics may be used as first choices. If a patient is not improving after five days of treatment with amoxicillin, the patient may be switched to one of the above drugs or amoxicillin-clavulanate (Augmentin). Generally, an effective antibiotic needs to be continued for a minimum of 10-14 days. However, it is not unusual to need to treat sinus infection for 14-21 days. Some antibiotics are now thought to also reduce inflammation, independent of the anitbacterial activity.

Reviewed on 5/18/2016
References
REFERENCES:

US Federal Drug Administration. "Is Rinsing Your Sinuses Safe?"
<http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm>

Brook, I. MD. "Acute Sinusitis." Medscape. Jul 29, 2015.
<http://emedicine.medscape.com/article/232670-overview>

Brook, I. MD. "Chronic Sinusitis." Medscape. July 19, 2015.
<http://emedicine.medscape.com/article/232791-overview>

NeilMed Pharmaceuticals, Inc. NeilMed Sinusrinse Video.
<http://www.neilmed.com/usa/video.php>

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