How Long Should I Continue Antibiotics for a Nasal Infection
Will My Sinus Infection Clear Up On Its Own
Wellness Wednesday: Antibiotics for sinus infections?
Topics in this Post
- Family Medicine
The first few weeks of the common cold aren' fun, but the acute sinusitis that can develop afterwards doesn't help either. Unfortunately, sinus congestion and the common cold go hand in hand. Acute sinusitis frequently is caused by the common cold, but also can be caused by allergies and bacterial and fungal infections.
Should You Treat A Sinus Infection With Antibiotics
Over the past few months Ive seen patient after patient drag themselves to the clinic with coughing, sneezing, headaches and green or yellow nasal discharge, sometimes accompanied by ear and tooth pain. Some people with infection may experience fevers, chills or night sweats signs that the body is fighting a virus or bacteria. These are symptoms I expect as a primary care doctor especially during the spring seasons. They are the telltale signs of sinusitis. But if that sums up symptoms you have, do you need antibiotics? The question may be more complicated than you think.
Each year, more than 30 million Americans endure sinusitis an inflammation of sinus spaces surrounding the nose that makes it difficult to drain fluid that normally flows through the sinuses. Much like a detective weighing clues, us health providers use symptom severity and duration to determine the cause of a patients sickness.
The World Health Organization has called antibiotic resistance one of the biggest threats to global health, saying misuse of antibiotics in humans and animals is accelerating the process.
At a health professionals discretion, antibiotics can be prescribed if a person appears very sick or has any underlying chronic disease that may make them prone to becoming sicker.
When Does Antibiotic Resistance Occur
Antibiotic resistance occurs in a persons own body and within the community when certain drugs no longer work for a specific type of germ. This can occur when bacteria change in response to exposure to antibiotics so that the antibiotics no longer work efficiently against the bacteria.
Unfortunately, it's hard to know if a sinus infection is bacterial, viral, or has other causes based on symptoms alone. Because viral sinus infections tend to improve in 5 to 7 days, healthcare providers will usually only prescribe antibiotics if your symptoms go on for longer than this. A sinus infection that persists for longer than a week or continues to get worse during this time period is more likely to be bacterial.
Therefore, allergists and other specialists recommend limiting the use of antibiotics unless:
- Symptoms last over seven to 10 days
- A fever is present
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Antibiotics Are Not A Good First Choice For Sinus Infections
People often are quick to ask their doctor for an antibiotic prescription when they suffer from a bad flu or sinus infection. These infections can be annoying, with congested noses, headaches, pain all across the face and never-ending mucus. People just want to make the pain and discomfort go away and get on with their lives. Thats understandable, but antibiotics most likely wont better their situation, as has been shown in countless studies. This is because sinusitis, like most infections of the upper respiratory tract, are caused by viruses, not bacteria. And antibiotics only go after bacteria.
Actually, taking antibiotics can make you feel sicker, since your body is already weakened by the viral infection and now you expose it to the stress of antibiotics side effects. All antibiotics have side effects, so they should only be taken when it makes medical sense, such as when treating a bacterial infection.
More generally, you want to keep your antibiotics use at a minimum. Because the more you use antibiotics, the more likely you are to get ill in the upper respiratory tract in the future, as the antibiotics not just kill bad bacteria but also the good bacteria in your body that help protect your health.
It, therefore, is recommended not to immediately treat every sinus infections with antibiotics, but preserve them as heavy ammunition for the most severe cases.
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A More In Depth Explanation Of Sinusitis
Acute sinusitis causes the cavities around your nasal passages to become inflamed and swollen. This interferes with drainage and causes mucus to build up.
With acute sinusitis, it might be difficult to breathe through your nose. The area around your eyes and face might feel swollen, and you might have throbbing facial pain or a headache.
Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve within a week to 10 days.
In most cases, home remedies are all that's needed to treat acute sinusitis. However, persistent sinusitis can lead to serious infections and other complications. Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis.
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When Do You Really Need Antibiotics For That Sinus Infection
- By Monique Tello, MD, MPH, Contributor
It was February, and clinic was teeming with respiratory infections of all kinds: mostly the common cold, but also bronchitis, pneumonia, and sinus infections. The patients were coming in usually thinking that they needed antibiotics for their sinus infection, or another respiratory infection.The first patient on my schedule was a healthcare provider with sinus infection written down as her main issue.* Shed had about two weeks of nasal and sinus congestion which she blamed on a viral upper respiratory infection . Her two young kids had been sick with colds all winter, so she wasnt surprised to have these symptoms, along with endless postnasal drip and a cough.
Her congestion had improved a bit at one point, and she thought that she was finally getting better. But then, the day before her appointment, she awoke with throbbing pain between her eyes, completely blocked nasal passages, and, more concerning to her, green pus oozing from her left tear duct. She had body aches, chills, and extreme fatigue. Do I maybe need antibiotics? she asked.
When Antibiotics Are Needed
Historically, sinus infections, also called sinusitis, were often treated with antibiotics. But today, many allergists warn against the random use of antibiotics for a sinus infection.
Antibiotics can help eliminate bacterial sinus infections. But when a sinus infection is caused by allergies, a virus, or other causes such as a structural defect of the sinuses, an antibiotic will not help to alleviate symptoms.
The overuse of antibiotics is when they are prescribed for reasons other than when they are needed. Because of the common overprescribing of antibiotics for the type of sinus infections that do not warrant such treatment, many people have developed whats commonly referred to as antibiotic resistance.
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How Can I Prevent Sinusitis
Some of the home remedies used to treat sinus infections symptoms may help prevent sinusitis. These include rinsing your nose out with salt water and using medications that your provider might suggest, such as allergy medications or steroid nasal sprays.
You should avoid things you are allergic to, like dust, pollen or smoke, and try to avoid sick people. Wash your hands to reduce your chance of getting a cold or flu.
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What You Need To Know About Sinus Infections
Do Antibiotics Help With Sinus Infections?
As the fall months approach, the potential for seasonal allergies, runny noses and sinus infections increases.
Sinus infections happen when fluid builds up in the air-filled pockets in the face. This allows germs to grow. Viruses cause most sinus infections, but bacteria can also be the culprit.
However, Jessica Grayson, M.D., an assistant professor with the University of Alabama at BirminghamDepartment of Otolaryngology, says many people confuse sinus infections for sinus pressure.
When people say they have sinus pressure, they may mean nasal congestion, Grayson said. Bilateral congestion could mean a person has a viral infection or an allergic reaction. Viral infections dont pick and choose a side.
Grayson adds that people who live in more humid climates like the South tend to suffer more from seasonal allergies because the humidity allows more fungus to grow, and long growing seasons allow for other trees, grasses and weeds. Living in cities can also affect people with allergies due to dust mites.
If your sinus pressure is isolated, you might have a bacterial infection, she said. Thats when you really should go see a doctor. With a virus, you just have to let it run its course.
Some people do get repetitive events, and people who work with small children, such as teachers or day care workers, are more likely to get recurrent viral infections.
Treatment
Jessica Grayson, M.D.That pesky flu
Aftermath
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When To Use And Avoid Antibiotics And Other Treatments To Try
A sinus infection can be treated with antibiotics when it is caused by bacteria. Sinus infections that have other causes, such as allergies or viruses, won't benefit from antibiotics.
Most sinus infections don't need antibiotics and will start to get better without treatment. Healthcare providers typically only prescribe antibiotics for sinus infections that don't clear up on their own.
This article looks at what types of sinus infections can be treated with antibiotics. It also discusses over-the-counter treatments and home remedies.
Your Sinus Infection Natural Treatment
Obviously, you shouldnt use ALL of these remedies TOGETHER. Just choose a few of them, the most available to you, and youre set.
A few combinations you can try are:
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What Can I Do To Help Myself Recover
Your recovery time after sinus surgery depends on your personal health and the type of procedure you have. Your surgeon will tell you what to expect. But you may need to stay home from work for at least a week after your surgery. This may feel overwhelming, but the good news is, there are things you can do to help your recovery after sinus surgery:
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Attend follow-up visits with your surgical team. After surgery, its important to follow up with your provider as instructed. At these visits, your provider will clean out blood and fluid from your nose and sinuses. These visits are important to make sure you are recovering well and to help your sinuses heal.
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Flush your sinuses. You will be instructed to flush out your sinuses after surgery at least twice a day. Nasal irrigation devices, such as neti pots and squeeze bottles, help to clear debris and mucus. Its best to follow these instructions in order to heal quickly.
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Do not smoke. Smoking interferes with the healing process and can result in failure of the surgery.
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Avoid straining. Try to avoid straining, such as blowing your nose too hard or lifting anything greater than 20 pounds for 1 to 2 weeks. Straining yourself can worsen bleeding.
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Avoid aspirin and NSAIDs. Dont take aspirin or NSAIDs for 1 to 2 weeks after surgery because these can worsen bleeding.
If you have questions about your instructions, or if you have unexpected discomfort, please contact your surgical team.
What Happens When Unnecessary Antibiotics Are Prescribed
Research shows that even bacterial infections can clear up on their own without antibiotics within one to two weeks. This means that the majority of the time, antibiotics are unnecessarily prescribed. Of all sinus infections, 85% clear up on their own, while only 15% do not. This 15% is the population that needs antibiotics.
Consuming antibiotics, even when you need them, increases side effects and bacterial resistance rates. This means that the more antibiotics prescribed, the more the bacteria will adapt to become resistant to that specific antibiotic. And there are only so many antibiotics to go around, so resistance should not be taken lightly. Thats why the overprescription of antibiotics is a public health emergency.
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Check If You Have Sinusitis
Sinusitis is common after a cold or flu.
Symptoms of sinusitis include:
Signs of sinusitis in young children may also include irritability, difficulty feeding, and breathing through their mouth.
The sinuses are small, empty spaces behind your cheekbones and forehead that connect to the inside of the nose.
Sinusitis causes the lining of the sinuses to swell up.
This stops mucus draining into your nose and throat properly, making you feel blocked up.
Duration Of Sinus Infection
Acute sinusitis causes inflammation and symptoms that often develop quickly and last 7 to 10 days if caused by a viral infection. But the illness can last for up to 4 weeks if its caused by a bacterial infection.
Chronic sinusitis lasts for 12 weeks or more. This inflammation can continue for months or years more, and people often describe them as a never-ending cold.
Sinusitis may also be classified as:
- Subacute, in which symptoms last for more than 4 weeks but less than 12 weeks
- Recurrent acute, in which there are at least four acute sinus infection episodes within one year
- Acute exacerbation of chronic rhinosinusitis, in which symptoms worsen in a person with chronic sinusitis
But having symptoms of sinusitis doesnt always mean that you have a sinus infection.
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How Long Does A Sinus Infection Last Over The Counter
Also, some of my patients spray nasal decongestants, like Afrin. But if used for more than three days, these over-the-counter medicines can cause more sinus swelling. Viral sinusitis should resolve in less than 10 days. But if the sickness is linked to allergies or bacterial infection, symptoms can last longer.
Ways To Recognize Serious Signs Of Sinus Infections
Are antibiotics needed for a sinus infection?
#1: Duration
The length of the infection is an important determinant of the seriousness of the infection.
I usually consider most infections less than 3 weeks to be viral or inflammation related to congestion. At this point, the best treatment is usually medications that decrease the congestion and inflammation. This in turn will alleviate the symptoms and ultimately cure the illness.
When the illness continues beyond 3 weeks, bacterial infection can begin to develop. Though antibiotics can be considered at this point, other treatments may still be the best answer if they have not yet been given a try.
#2: Mucous Color
I will dispel a myth right here and now. Yellowish/greenish mucous does not necessarily mean the infection is bacterial.
Viruses can cause the same color mucous. The reason for the mucous is generally not the actual bacteria or virus, but the bodys immune response to the intruder.
So dont worry just because you see a colored mucous when you blow your nose. This will also improve as the infection abates.
#3: Sinus Pain
Sinus pain can occur anytime throughout a sinus infection. This is normal and means there is inflammation in the sinuses, as we discussed previously.
However, severe pain, redness over the skin, hardened skin over the sinuses, or even a severe headache are not generally normal and can indicate a bacterial infection.
#4: Fever
A fever can be caused by both viruses and bacteria. So how do you differentiate between the two?
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Why Do I Need Antibiotics For Sinus Infection
You should use antibiotics for a sinus infection when it is clear that its been caused by bacteria.
Its probably a bacterial infection if you notice the following:
- Symptoms persist for seven days or more, especially if they seem to get better and then worsen.
- Your mucus is yellow or green and thick.
- Your facial or sinus tenderness is severe, mainly if one side of your face is worse.
- Pain in your upper teeth area is worse on one side.
Contact your physician if the infection becomes severe, comes back, or isnt getting better on its own.
How Long Does Sinusitis Last
There are a few types of sinusitis, and doctors can classify them by how long they last. These classifications can include:
Acute sinus infections with a four-week duration or less
Subacute infections that last for roughly four to 12 weeks
Chronic conditions that fall over 12 weeks
Recurrent infections that recur many times throughout the year
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Is Your Sinus Infection Caused By A Virus Or Bacteria
Physicians may not know if sinusitis is bacterial or viral, because the diagnosis is typically done by observing symptoms. Symptoms include:
- Nasal congestion
- Thick nasal or post-nasal drainage
Sometimes other tests such as computed tomography scan or cultures are used to help make the diagnosis.
Despite the recommendations that antibiotic use be judicious, they are still overused for sinusitis, according to many physicians who specialize in treating sinus problems.
Some physicians say they give patients with sinusitis a prescription for antibiotics, and recommend they wait three to five days before filling it, and only fill it if symptoms are not better by then. A can be used to help relieve your symptoms and promote drainage.
The longer symptoms last, the more likely a sinus problem is to be a bacterial infection, some experts say.
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Source: https://www.infectiontalk.net/i-need-antibiotics-for-sinus-infection/
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