Should people treat sinus infection with antibiotics?

Depending on the cause, doctors may prescribe antibiotics for sinus infection, also called sinusitis.

When an individual has a sinus infection, fluids accumulate in the air-filled cavities in the face. Typically, these sinuses have a thin lining of mucus that collects dust, germs, and other particles from the air.

Tiny hair-like projections, called cilia, sweep the mucus and any particles trapped down the back of the throat into the stomach. However, in sinusitis, the mucus does not flow freely, and germs can multiply.

Sinusitis, also called rhinosinusitis, is one of the most common reasons people visit doctors in the United States. Almost 15% of the population experiences sinus infections each year, and it is one of the top conditions that doctors prescribe antibiotics for.

This article looks at antibiotics for a sinus infection, their benefits, and alternative treatment methods, including some natural remedies.

An individual does not always need antibiotics for a sinus infection. Many sinus infections improve without antibiotic treatment. In addition, because many sinus infections are viral in origin, antibiotics do not help in these cases and can cause unpleasant side effects.

Side effects can range from minor problems such as rashes to severe health issues, including antibiotic-resistant infections.

People should therefore discuss their symptoms with a doctor and find out the best treatment for them. Doctors will only recommend antibiotics when they suspect bacterial sinusitis.

Antibiotics are beneficial for bacterial sinusitis only. If an individual has a viral, fungal, or other sinus infection, antibiotics do not offer any benefits.

If a person has bacterial sinusitis, treatment with appropriate antibiotics can help resolve the infection. However, evidence shows that antibiotic therapy may not shorten symptom duration or lessen the likelihood of developing complications.

In fact, research shows that antibiotic treatment cures just 5–11% of people more quickly than if they receive no treatment. Many cases of bacterial sinusitis clear up by themselves within two weeks.

Doctors often suggest 10–14 days of treatment with amoxicillin or amoxicillin-clavulanate if an individual has bacterial sinusitis.

However, amoxicillins have become less effective in some areas because of antibiotic resistance. In these cases, a doctor may suggest switching to another antibiotic if there is no improvement in symptoms after a few days. The alternatives include:

doxycycline
fluoroquinolones
cefixime with clindamycin

Doctors may recommend the following nonantibiotic treatments for sinusitis:

Nasal decongestants: Over-the-counter nasal decongestant sprays can help relieve symptoms of stuffiness. Options include pseudoephedrine and oxymetazoline. However, people should only use them for up to three days.
Antihistamines: People with early stage allergic sinusitis may find these allergy medications helpful.
Nasal corticosteroid sprays: These medications reduce inflammation and swelling in the sinuses. However, they are most effective in chronic and allergic sinusitis.
Pain relievers: Using acetaminophen or ibuprofen may help if an individual experiences facial pain.

Individuals with sinus infections could find the following natural remedies helpful in relieving uncomfortable symptoms:

Resting: Resting while the body fights infection helps speed recovery.
Humidifying the air: Keep the air moist with a humidifier or cool air vaporizer.
Nasal washing: Saline nasal rinses can help flush out allergens, germs, and mucous plugs from the sinuses. People can also use a neti pot with previously boiled and cooled water.
Drinking fluids: Drinking plenty of water or fruit juice helps keep the mucous membranes moist and promotes proper drainage from the sinuses.
Inhaling steam: This involves pouring boiled water into a large bowl and leaning over while inhaling the water vapor. Usually, the individual drapes a towel over the back of their head, creating a tent over the bowl to trap the steam. The moist, hot air helps ease sinus pain and drainage. People can enjoy a similar effect from a hot shower.
Using a warm compress: Applying heat to the sinuses using a warm washcloth may help ease uncomfortable sinus pressure. Ensure the compress is not hot enough to harm the skin.
Elevating the head while sleeping: This position allows the sinuses to drain more easily and reduces congestion.

People may experience the following symptoms of sinus infections:

facial pain
facial pressure
runny nose
blocked nose
headache
mucus at the back of the throat
sore throat
cough
bad breath

A combination of environmental and other factors can cause sinus infections, including:

viruses
bacteria
fungi
allergens such as pollen
irritants such as smoke and dust

Viruses are the most common cause of sinus infections, and around 90% of people with colds have some form of viral sinusitis.

Viral sinusitis is usually self-limiting. However, an individual should make an appointment with their doctor if they experience the following:

worsening symptoms
severe headaches or facial pain
symptoms that do not improve after 10 days
a fever lasting longer than 4 days
any concerning symptoms

Additionally, people should seek medical attention if they have had multiple sinus infections in the past year.

A sinus infection causes fluids to accumulate in the air-filled cavities in the face, and mucus no longer flows freely. Viruses and bacteria can then multiply and cause uncomfortable symptoms. These include facial pain, a runny or stuffy nose, and a cough.

Sinus infections can also occur due to irritants, allergens, and fungi.

Individuals do not always need antibiotics for sinus infections and using them when unnecessary can lead to unpleasant side effects. However, if a doctor believes the cause is bacterial, they may prescribe them.

If a person has bacterial sinusitis, antibiotics can help. But it is important to note that most cases of bacterial sinusitis clear up without treatment within 2 weeks.

People can help ease symptoms by inhaling steam, keeping the surrounding air moist, using nasal decongestants, and taking over-the-counter pain-relieving medication.

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