Sinus Problems: Do Antibiotics Help or Hurt?
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
- Pain or discomfort around the eyes, forehead or cheeks
- Thick nasal or post-nasal drainage
Sometimes other tests such as computed tomography (CT) 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 decongestant 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. Clear white mucus often accompanies a viral sinus problem, and yellow or green mucus more likely indicates a bacterial sinus infection.
When Antibiotics Are Appropriate Treatment
Antibiotics may be more appropriate to give to certain patients, such as those with diabetes, serious heart or lung disease, who are less able to fight off infection.
And antibiotics should be considered in patients with severe sinusitis symptoms, according to the practice guidelines from the American Academy of Allergy, Asthma and Immunology.
If antibiotics are given, a 10- to 14-day course is recommended, according to the practice guidelines. Amoxicillin is typically the first choice if you are not allergic to penicillin.