How long does it take for a sinus infection to go away with antibiotics

Q: Why wont my sinus infection go away with antibiotics?

Most sinus infections are caused by viruses, which dont respond to antibiotics. But even bacterial sinus infections rarely require antibiotic treatment, according to the Centers for Disease Control and Prevention. In most cases, both types of infection go away on their own in less than two weeks.

(Reuters Health) - Most people prescribed antibiotics for sinus infections are on treatment courses of 10 days or longer even though infectious disease doctors recommend five to seven days for uncomplicated cases, a U.S. study suggests.

Table of Contents Show

Sinus Infection (Sinusitis)
Risk Factors
When to Seek Medical Care
How to Feel Better
Over-the-Counter Medicine and Children
How long after starting antibiotics for sinus infection will I feel better?
What is strongest antibiotic for sinus infection?
Why won't my sinus infection go away with antibiotics?
Will antibiotics clear up a sinus infection?

Researchers examined data from a sample representing an estimated 3.7 million adults treated for sinusitis and prescribed antibiotics in 2016. Overall, 70 percent of antibiotics prescribed were for 10 days or longer, the study found.

“Any time antibiotics are used, they can cause side effects and lead to antibiotic resistance,” said senior study author Dr. Katherine Fleming-Dutra, deputy director of the Office of Antibiotic Stewardship at the U.S. Centers for Disease Control and Prevention in Atlanta.

“This is why it is so important to only use antibiotics when they are needed and to use the right antibiotic for the minimum effective duration,” Fleming-Dutra said by email.

Common side effects of antibiotics can include rash, dizziness, nausea, diarrhea and yeast infections, she said. More serious side effects may include life-threatening allergic reactions and Clostridium difficile infection, which causes diarrhea that can lead to severe colon damage and death.

Antibiotic resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them and can make infections harder to treat.

When antibiotics are prescribed for sinus infections, only five to seven days of therapy are needed for uncomplicated cases, when patients start to recover within a few days of starting treatment and if they don’t have signs that the infection has spread beyond the sinuses, according to the Infectious Diseases Society of America (IDSA).

These guidelines are relatively new, however, and it’s possible some of the longer courses of antibiotics prescribed in the study occurred because not all doctors have absorbed the new practice recommendations, Fleming-Dutra said. Prior to 2012, the IDSA recommended 10 to 14 days of antibiotics for sinus infections in adults.

In the study, no penicillin or tetracycline prescriptions were for five-day courses and only 5 percent of prescriptions were for seven-day courses of penicillins, tetracyclines or fluoroquinolones.

When researchers excluded azithromycin, an antibiotic that’s not recommended for sinus infections, they found that 91 percent of all antibiotic courses prescribed for sinus infections were for 10 days or longer.

The study didn’t examine whether or how the duration of antibiotics prescriptions impacted treatment of sinus infections or the potential for side effects.

Researchers also focused only on acute sinus infections, and by excluding some cases where the type of infection was unclear, they may have left out some acute cases, the study team notes in JAMA Internal Medicine.

It’s also possible that in some cases, doctors prescribed antibiotics for 10 days or longer and instructed patients to stop after five to seven days unless they were still experiencing symptoms, said Dr. Sharon Meropol, a researcher at Case Western Reserve University School of Medicine in Cleveland, Ohio, who wasn’t involved in the study.

One pitfall in this approach is that when patients improve slowly, it’s possible they’re infected with organisms that are resistant to the antibiotic they got prescribed, and they would recover faster if they switched to a different antibiotic instead of continuing the current one longer, Meropol said by email.

“Older . . . acute bacterial sinusitis guidelines were written with the belief that if antibiotics were taken for shorter durations of time, that the bacteria would not be completely eradicated and that would risk persistent, recurrent and antibiotic resistant infections,” Meropol said.

“But the recommendations have changed on this because subsequent studies have shown the opposite is true, that in fact if the patient is responding to treatment, five to seven days is safe and is usually enough,” Meropol added. “A longer treatment is not usually needed.”

SOURCE: bit.ly/2Gpq29Z JAMA Internal Medicine, online March 26, 2018.

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Sinus Infection (Sinusitis)

Stuffy nose that just isn’t getting better? You might have a sinus infection, also called sinusitis

Antibiotics are not needed for many sinus infections, but your doctor can decide if you need an antibiotic.

Causes

Sinus infections happen when fluid builds up in the air-filled pockets in the face (sinuses). This fluid buildup allows germs to grow. Viruses cause most sinus infections, but bacteria can cause some sinus infections.

Risk Factors

Several factors can increase your risk of getting a sinus infection:

A previous cold
Seasonal allergies
Smoking and exposure to secondhand smoke
Structural problems within the sinuses. For example, growths on the lining of the nose or sinuses, known as nasal polyps.
A weak immune system or taking drugs that weaken the immune system

Symptoms

Common symptoms of sinus infections include:

Runny nose
Stuffy nose
Facial pain or pressure
Headache
Mucus dripping down the throat (post-nasal drip)
Sore throat
Cough
Bad breath

When you have a sinus infection, one or more of your sinuses becomes inflamed. Fluid builds up, which can cause congestion and runny nose.

Talk to a healthcare professional right away if your child is under 3 months old with a fever of 100.4 °F (38 °C) or higher.

When to Seek Medical Care

See a doctor if you have:

Severe symptoms, such as severe headache or facial pain.
Symptoms that get worse after improving.
Symptoms lasting more than 10 days without getting better.
Fever longer than 3-4 days.

You should also seek medical care if you have had multiple sinus infections in the past year.

This list is not all-inclusive. Please see a doctor for any symptom that is severe or concerning.

Other conditions can cause symptoms similar to a sinus infection, including:

Seasonal allergies
Colds

Treatment

Your doctor will determine if you have a sinus infection by asking about symptoms and examining you.

Antibiotics are not needed for many sinus infections. Most sinus infections usually get better on their own without antibiotics. When antibiotics aren’t needed, they won’t help you, and their side effects could still cause harm. Side effects can range from mild reactions, like a rash, to more serious health problems. These problems can include severe allergic reactions, antibiotic-resistant infections and C. diff infection. C. diff causes diarrhea that can lead to severe colon damage and death.

However, in some cases, you may need antibiotics. Talk to your doctor about the best treatment for your illness.

For some sinus infections, your doctor might recommend watchful waiting or delayed antibiotic prescribing.

Watchful waiting: Your doctor may suggest watching and waiting for 2-3 days to see if you need antibiotics. This gives the immune system time to fight off the infection. If your symptoms don’t improve, the doctor may prescribe an antibiotic.
Delayed prescribing: Your doctor may prescribe an antibiotic but suggest that you wait 2–3 days before filling the prescription. You may recover on your own and may not need the antibiotic.

How to Feel Better

Below are some ways to help relieve sinus pain and pressure:

Put a warm compress over the nose and forehead to help relieve sinus pressure.
Use a decongestant or saline nasal spray.
Breathe in steam from a bowl of hot water or shower.

Ask your doctor or pharmacist about over-the-counter medicines that can help you feel better. Always use over-the-counter medicines as directed.

Over-the-Counter Medicine and Children

Carefully read and follow instructions on over-the-counter medicine product labels before giving medicines to children. Some over-the-counter medicines are not recommended for children of certain ages.

Pain relievers:
- Children younger than 6 months: only give acetaminophen.
- Children 6 months or older: it is OK to give acetaminophen or ibuprofen.
- Never give aspirin to children because it can cause Reye’s syndrome. Reye’s syndrome is a very serious, but rare illness that can harm the liver and brain.

Cough and cold medicines:
- Children younger than 4 years old: do not use over-the-counter cough and cold medicines in young children unless a doctor specifically tells you to. Cough and cold medicines can result in serious and sometimes life-threatening side effects in young children.
- Children 4 years or older: discuss with your child’s doctor if over-the-counter cough and cold medicines are safe to give to your child.

Ask your doctor or pharmacist about the right dosage of over-the-counter medicines for your child’s age and size. Also, tell your child’s doctor and pharmacist about all prescription and over-the-counter medicines they are taking.

Prevention

You can help prevent sinus infections by doing your best to stay healthy and keep others healthy, including:

Clean your hands.
Receive recommended vaccines, such as the flu vaccine and pneumococcal vaccine.
Avoid close contact with people who have colds or other upper respiratory infections.
Don’t smoke and avoid secondhand smoke.
Use a clean humidifier to moisten the air at home.

How long after starting antibiotics for sinus infection will I feel better?

Antibiotics work in most cases of acute sinusitis that are caused by bacteria. Most people start feeling better 3 to 4 days after they start taking the medicine. Antibiotics won't work for infections caused by a virus. Over-the-counter medicines and home treatment can help you feel better.

What is strongest antibiotic for sinus infection?

Amoxicillin remains the drug of choice for acute, uncomplicated bacterial sinusitis. Amoxicillin is most effective when given frequently enough to sustain adequate levels in the infected tissue. While often prescribed twice daily, it is even more effective if taken in 3 or 4 divided doses.

Why won't my sinus infection go away with antibiotics?

Most sinus infections are caused by viruses, which don't respond to antibiotics. But even bacterial sinus infections rarely require antibiotic treatment, according to the Centers for Disease Control and Prevention. In most cases, both types of infection go away on their own in less than two weeks.

Will antibiotics clear up a sinus infection?

Antibiotics are not needed for many sinus infections. Most sinus infections usually get better on their own without antibiotics. When antibiotics aren't needed, they won't help you, and their side effects could still cause harm. Side effects can range from mild reactions, like a rash, to more serious health problems.