When Do I Need Antibiotics for Sinus Infection- Everything to Know

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Do I need antibiotics for sinus infection? Using antibiotics to treat a sinus infection depends on what caused the infection- a virus or a bacterium. Doctors won’t prescribe an antibiotic if your sinus infection starts because of a virus. So let’s dive into this a bit more.

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Do I Need Antibiotics for Sinus Infection?

A person doesn’t always require antibiotics to cure sinusitis. This is because most sinusitis will get better with different treatments. Additionally, since a virus causes most sinusitis conditions, antibiotics won’t help a person get better and can cause unwanted side effects.

Side effects can range from minor rashes to severe health conditions, including antibiotic-resistant infections. You should discuss your symptoms with your physician and find the best treatment for your specific cause. For example, doctors only suggest antibiotics when they believe you have bacterial sinusitis.

How well do antibiotics work for sinusitis?

Antibiotics can only be effective against bacterial sinusitis. Antibiotics won’t help if an individual has viral, fungal, or another type of sinusitis.

When do I need antibiotics for sinus infection? If you have bacterial sinusitis, treatment with the right antibiotics will help eliminate the infection. However, it is essential to remember that some studies show that antibiotic therapy doesn’t always lessen symptom duration or the chance of developing complications.

According to recent statistics, antibiotic treatment cures five to 11% of people faster than if they didn’t get treatment. Additionally, several cases of bacterial sinusitis go away by themselves in about two weeks.

Best Antibiotic treatment for sinus infection

Physicians frequently recommend ten to 14 days of amoxicillin or amoxicillin-clavulanate treatment when a person has bacterial sinusitis.

However, amoxicillin is less effective in some areas because of antibiotic-resistant bacteria. In these cases, a physician could recommend using another antibiotic when there is no improvement in sinusitis symptoms after a couple of days.

Some alternatives to treat sinusitis include:

  • Doxycycline
  • Fluoroquinolones
  • Cefixime with clindamycin
8 Symptoms of a Sinus Infection

Most common antibiotics used for sinusitis

The most commonly recommended antibiotic for acute, uncomplicated bacterial sinusitis is amoxicillin.

It’s most effective when the patient takes it frequently enough to maintain adequate levels in the infected tissue. Often, doctors prescribe it twice daily, though three or four divided doses can be even more effective. Amoxicillin is usually prescribed for seven to ten days. While it is crucial to finish the entire ten-day course of antibiotics for strep throat, shorter courses could be sufficient for several cases of sinusitis.

Azithromycin is an alternate treatment option for those who are allergic to amoxicillin. The primary benefit of azithromycin is expediency. The suggested treatment for acute bacterial sinus infections is 500 mg once daily for three days. Unlike amoxicillin, azithromycin is even more effective when doctors prescribe a sizeable single dose instead of spreading the doses out.

What are the benefits of antibiotics for Sinus Infections?

Antibiotics work most of the time for acute sinusitis caused by bacteria. Most sick individuals start to feel better after three to four days of taking them.

Why Do I Need Antibiotics for Sinus Infection?

You should use antibiotics for a sinus infection when it is clear that it’s been caused by bacteria.

It’s 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 isn’t getting better on its own.

Sinusitis Resistance to Antibiotic

Bacteria resistance to antibiotics is a big problem throughout the United States. Several common bacteria behind sinusitis can carry a gene that makes them resistant to the effects of antibiotics. You’ll notice this after a few days of treatment when the gene activates. It can even travel between bacteria in a plasmid capsule, affecting a large population of bacteria.

When you don’t show improvement after a course of antibiotics within four to seven days, especially if you did seem better at first but then got worse again, you might be dealing with resistant bacteria. Talk to your physician about an examination and potential culture or sinus DNA analysis. These tests can identify the most harmful resistant strains within about 24 hours and offer a comprehensive bacterial analysis within one week.

Risk of Unnecessary Antibiotics for Sinus Infections

Taking antibiotics when a bacterium doesn’t cause your sinus infection won’t help you feel better, prevent the spread of the illness, or cure it. It’s possible that if you take antibiotics too often, you won’t find success with them when you do need them.

If you do take antibiotics, follow your instructions to the letter. Even after you start feeling better, finish your antibiotic course. You’ll want to ensure the medicine eliminates all the bacteria and you don’t get sick again.

When to contact a doctor

Reach out to your physician or a doctor if you have severe symptoms or if the following symptoms persist for longer than ten days or keep returning:

  • Fever
  • Congestion
  • Nasal discharge
  • Facial and sinus pain

Because the cause of your sinus infection will determine the appropriate treatment options, it’s crucial to see a doctor for a diagnosis sooner rather than later. Several online tools can help you find a local provider covered by your insurance.

If you think you have a chronic or recurring sinus infection, think about getting a referral to an otolaryngologist, also called an ear, nose, and throat (ENT) doctor. A CT scan and other diagnostic tests might be necessary to determine the cause of your condition.

Going to the ENT

An ENT or nose, ear, and throat specialist can collect a culture of your nose drainage to understand your sinus infection. The ENT can also assess the sinuses more in-depth and identify any issues with your nasal passages’ structure, leading to ongoing sinus problems.

With both chronic and acute sinusitis, fever is not typically a symptom. However, it’s possible. If you have an underlying condition affecting your chronic infections, you may need to visit a specialist for treatment.

Conditions that cause chronic infections can include:

  • Allergies
  • Nasal polyps
  • A deviated septum

A physician can attempt to determine the cause of your sinus infection and provide treatment options that suit your unique situation. Contact a professional healthcare provider immediately if you experience symptoms that indicate a more severe condition, including:

  • A fever higher than 103°F
  • Mental issues or confusion
  • A stiff neck
  • Vision changes or issues
  • Symptoms related to these that are concerning or severe

Frequently Asked Questions

Yes, certainly. Suppose your doctor prescribes an antibiotic to treat your sinusitis. Not only should you take it, but you should complete the regimen and leave nothing leftover. 

Yes, it can. Suppose your sinusitis is related to a virus and generally not bacterial in nature. In that case, it can improve and resolve on its own. Some cases of bacterial infection can also improve without antibiotics. In addition, home remedies like using a neti pot, drinking plenty of fluids, and a saline nasal spray can be effective. However, it’s essential to listen to the instructions from your physician and follow them for successful treatment. 

Antibiotics for sinusitis can help to decrease the length of time you’re sick and help you to feel better quicker. However, this isn’t always the case. Viruses and other irritants can also cause sinusitis. Therefore taking antibiotics when you don’t need them can create antibiotic resistance in various bacteria. Antibiotic resistance is a more significant concern, so physicians are often careful to prescribe antibiotics for sinusitis unless the symptoms are severe.

Amoxicillin is typically used for acute bacterial sinusitis. It’s effective when used as described and is usually prescribed for a week to ten days. However, shorter regimens can also be effective.

Azithromycin is used for those allergic to amoxicillin and can work more quickly than amoxicillin. Five hundred milligrams daily for three days is adequate for acute bacterial sinusitis. It’s very effective when doctors prescribe a sizeable single dose at the start of treatment.

The Z-Pak is a three or five-day regimen of azithromycin antibiotics. Suppose your physician determines that your sinusitis is bacterial and you are allergic to common penicillin-based antibiotics. They may prescribe the Z-Pack. By the end of the course of antibiotics, your condition and symptoms should be resolved. However, it’s possible to have an antibiotic-resistant strain. Typically, patients start to feel better once the antibiotics have built up enough in the body to have killed a high enough amount of bacteria, around three days for the longer course.

Bacterial sinusitis frequently comes after a viral infection, like a cold or the flu. Viral infections often cause the mucosal lining of the sinuses to become inflamed and irritated. In healthy sinuses, mucus freely flows into the nasal cavity through tiny holes called ostia. However, they can block these holes when the mucus membranes swell in the nose or sinus cavities. This keeps your sinuses from adequately draining and flushing your system of irritants and germs. As a result, bacteria build up in the undrained mucus, typically leading to bacterial sinusitis.

Look for the symptoms of bacterial sinusitis as mentioned earlier when you’re looking to determine whether or not you should go to the doctor for antibiotics. Additionally, visit your physician immediately if any of your symptoms seem especially severe or won’t go away. Your doctor may recommend sinus surgery, depending on the severity of your condition.

If you’re looking for more information on antibiotics or nasal issues, please see our other resources available here. We hope this information helped you, and remember, if you’re ever unsure about your symptoms or health, just go to a doctor.

The content on Doctor Alexa’s blog is reviewed by Advanced practice registered nurses or pharmacist and is intended for educational purposes only. This information should not be relied upon as professional medical counsel. Be sure to always consult with your physician about the dangers and benefits of any medication, treatment or procedure.

You shouldn’t wait to see the doctor for simple health needs.