Sinusitis
Treatment Overview
Sinusitis is treated with medications and home treatment methods, such as applying moist heat to your face. The goals of treatment for sinusitis are to:
- Improve drainage of mucus and reduce swelling in the sinuses.
- Relieve pain and pressure.
- Clear up any infection.
- Prevent the formation of scar tissue, and avoid permanent damage to the tissues lining the nose and sinuses.
Medications may be used to treat sinusitis, especially when it is caused by a bacterial infection. There are varying lengths of treatment with medications—treatment may be as short as three days or last as long as several weeks or more. Medications most often used to treat sinusitis include a combination of:
- Antibiotics, such as amoxicillin, which kill bacteria.
- Decongestants, such as pseudoephedrine hydrochloride, which reduce the swelling of the mucous membranes in the nose.
- Analgesics, such as aspirin, acetaminophen, or ibuprofen, to relieve pain.
- Mucolytics, such as guaifenesin, which thin the mucus.
- Corticosteroids, such as beclomethasone dipropionate or prednisone, which reduce inflammation in the nasal passages. These medications may also be used as an inhaled nasal spray.
Inhaled antibiotics are a fairly new treatment choice for chronic sinusitis. Initial studies show that since inhaled antibiotics make direct contact with the mucous membranes, they may be effective when other treatments have failed.1
It is possible to develop "double sickening" while being treated for acute or chronic sinusitis. At first, you may begin to feel better from antibiotics and home treatment, but then your symptoms become worse and additional treatment may be needed.
For acute sinusitis
Short-term (acute) sinusitis usually lasts less than 4 weeks. Up to two-thirds of people with acute sinusitis improve on their own without antibiotic treatment.2 Sinus infections are commonly caused by viral infections, which do not respond to antibiotics. Antibiotics may cause bothersome side effects (such as diarrhea or upset stomach) and also may contribute to your becoming resistant to antibiotics in the future. Talking with your health professional will help you determine whether treatment with antibiotics is needed for your acute sinus infection.
After one or two bouts of sinusitis, you may be able to recognize the early symptoms of a sinus infection. Using steam to relieve nasal congestion at the first sign of a sinus infection may relieve your symptoms and prevent the need for antibiotics. For more information, see the Home Treatment section of this topic.
Most people recover completely when treated with an antibiotic for acute sinusitis that is caused by a bacterial infection. The number of days you take antibiotics depends on the antibiotic and the severity of the infection. When you are prescribed an antibiotic, be sure to take it until it is gone, even if you feel better. It is important to always take an antibiotic exactly as your health professional tells you, or the infection may not go away completely.
If symptoms get worse during antibiotic treatment, contact your health professional. You may need to take the antibiotic longer, or you may need to try a different antibiotic.
If you had a sinus infection that lasted a long time, it may take weeks or months for the mucous membranes that line your nose and sinuses to fully recover, and some minor symptoms may continue after the bacteria have been killed. During this time, there is an increased chance that the infection may return. Longer treatment with antibiotics may be needed.
Decongestants and medications that thin mucus may also be used. Do not give cough and cold medicines to a child younger than 2 unless your child’s doctor has told you to. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do.
For chronic sinusitis
Sinusitis that lasts 8 weeks or longer is called chronic sinusitis. It is more difficult to treat and responds more slowly to antibiotics than acute sinusitis.
Antibiotic therapy is usually recommended for chronic sinusitis and may require a longer course of treatment. You may need to try more than one antibiotic. A corticosteroid nasal spray that reduces inflammation and swelling of the lining of the nasal passages may also be used during treatment.
In some people, a sinus infection may be caused by a fungus or a bacterium other than those normally associated with sinusitis. People who have an impaired immune system are at risk for these unusual infections. It also may include people who must use an oral or inhaled corticosteroid medication (such as prednisone). Fungal sinusitis, which accounts for a significant number of chronic sinusitis cases, does not respond to antibiotic treatment and may need treatment with antifungal medications, corticosteroids, or surgery.
Surgery may be required if you have taken antibiotics for an extended period of time but still have symptoms or when complications (such as infection of facial bones) are likely. For more information, see:
What To Think About
Sinusitis may be difficult to diagnose because it often causes the same symptoms as a cold or other viral illness, especially in its early stages. It can be particularly difficult to identify sinusitis in children. If your child or you have frequent sinus infections, learn what signs to watch for, and begin home treatment immediately.
Symptoms of chronic sinusitis are often vague and may not respond well to treatment. It may take time and patience to find a successful treatment.
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| Author: | Shannon Erstad, MBA/MPH | Last Updated: August 15, 2008 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Donald R. Mintz, MD - Otolaryngology | |
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