Medications
Medications may be needed when symptoms of
sinusitis are severe or do not improve. The goals of
treatment with medication are to:
- Treat the infection, which is usually caused by
bacteria if your symptoms have lasted more than 7 to 10
days.
- Relieve pressure and pain caused by poor sinus
drainage.
- Reduce
inflammation of the nose and sinuses caused by
allergies.
Antibiotic treatment is successful in most cases of
short-term (acute) sinusitis when it is caused by
bacteria. You should notice improvement within 3 to 4
days after you begin taking an antibiotic. The number of days you take
antibiotics depends on the antibiotic and the severity of the infection. It
takes weeks and sometimes months for the
mucous membranes that line the sinuses to fully heal
after an infection, so some minor symptoms may continue during this time. You
are more likely to develop another sinus infection while the membrane is still
healing.
Chronic sinusitis may last 8 weeks or longer and usually
requires 3 to 4 weeks of antibiotic treatment. Symptoms may persist or return
despite adequate antibiotic treatment. A different antibiotic may be needed to
treat the infection. Referral to an ear, nose, and throat (ENT) specialist
(also called an
otolaryngologist) may be needed if symptoms of
sinusitis do not go away despite long-term antibiotic treatment.
Medication Choices
Medications are used and sometimes combined to treat
sinusitis.
- Antibiotics kill bacteria. A few examples of
antibiotics used are amoxicillin (Amoxil and Trimox) and cefdinir
(Omnicef).
- Decongestants reduce the swelling of the mucous
membranes in the nose. Some examples may include oxymetazoline hydrochloride
(Afrin) and phenylephrine hydrochloride (Neo-Synephrine).
- Analgesics, such as aspirin, acetaminophen, or
ibuprofen, are used to relieve pain.
- Corticosteroids, such as beclomethasone dipropionate
monhydrate (Beconase AQ) or prednisone, reduce inflammation in the nasal
passages and may be given as an inhaled nasal spray.
- Mucolytics, such as guaifenesin (Robitussin), are used
to thin the mucus.
What To Think About
If you are taking antibiotics
for a sinus infection, do not stop taking the antibiotics early just because
you feel better. Take the entire course of antibiotics. The infection may not
go away if you do not take all of the antibiotics prescribed by your health
professional.
More powerful antibiotics may be needed to kill
bacteria that persist if there is no improvement after trying a first-line
antibiotic. Stronger antibiotics can be very costly and may have more side
effects.
Fungal sinusitis, which accounts for a
significant number of chronic sinusitis cases, does not respond to antibiotic
treatment. It may need treatment with antifungal medications, corticosteroids,
and surgery.