What Medication Is Best for Sinusitis?

Mild to moderate sinusitis

If the sinus congestion is mild, it can be relieved with medications such as:

• Decongestants
• Over-the-counter cold and allergy medications
• Nasal saline sprays

Severe sinusitis

If symptoms do not improve after 10 days, treatments may change to:

• Antibiotics
• Oral or topical decongestants
• Prescription intranasal steroid sprays

Chronic sinusitis

Chronic sinusitis is often treated by focusing on the underlying condition (which are typically allergies):

• Intranasal steroid sprays
• Topical antihistamine sprays or oral pills
• Leukotriene antagonists to reduce allergy symptoms

When sinusitis is not controlled with these treatments, a computed tomography scan may be taken to have a better look at the sinuses. Based on the results, surgery may be required to correct structural problems in the sinuses. This is often advised in the case of polyps and fungal infections.

• Acute sinusitis: Symptoms last for 4 weeks or less and may be due to bacterial or viral infections or allergies.
• Chronic sinusitis: Sinus swelling lasts for more than 3 months and may be due to bacterial or fungal infections.
• Subacute sinusitis: Sinus congestion lasts for 1-3 months.

The sinuses are air-filled cavities in the skull that are located behind the forehead, nasal bones, cheeks, and eyes. They produce thin mucus that drains out of the nose and keeps the nasal passages clear of germs and allergens.

When these sinus openings are blocked and traps mucus and air inside the sinuses, germs can grow more easily and cause infection.

Causes of sinusitis include:

• Medical conditions where small hair-like structures (cilia) present in the sinuses fail to properly drain mucus.
• Colds and allergies, which lead to too much mucus production or block the sinus cavities.
• Deviated nasal septum, nasal bone spurs, or nasal polyps that block the sinus cavities.

Risk factors for sinusitis include:

• Respiratory tract infections
• Seasonal allergies
• Allergies to dust, pollen, and pet dander
• Nasal polyps that can lead to obstruction and inflammation
• Weakened immune system due to human immunodeficiency virus or chemotherapy
• Abnormal sinus structures, such as deviated septum

Symptoms vary depending on the severity of the condition and may include:

• Stuffy nose and discharge
• Postnasal drip
• Pain behind the eyes or face
• Sore throat 
• Cough that is often worse at night
• Bad breath or loss of smell
• Fatigue and a general feeling of being ill
• Headache
• Fever

Although rare, untreated sinus infections can become dangerous if they lead to infection of the brain, eyes, or surrounding bones. This can cause conditions such as:

• Brain abscess
• Meningitis
• Orbital abscess
• Orbital cellulitis
• Mastoiditis