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Sinus Infection

Sinus Infection

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Updated June 24, 2014

Sinus Infection

Chronic sinusitis is often caused by inflammation and blockage due to physical obstruction such as a deviated septum, misformed bone or cartilage structures such as the nasal conchae (turbinates), or blockage by nasal cysts or polyps.

A.D.A.M.

How are Sinus Infections Diagnosed?

A sinus infection is diagnosed based on a person’s symptoms, findings when examined by a health professional, as well as x-rays or CT of the sinuses. X-rays and CTs are not often needed in uncomplicated acute sinusitis. However, imaging studies are very helpful in people with chronic or recurrent infections.

How are Sinus Infections Treated?

The main treatment for sinus infections is antibiotics. There are a wide variety of antibiotics that can be used to treat sinusitis, including amoxicillin, sulfamethoxazole-trimethoprim (Septra/Bactrim), cephalosporins, macrolides (such as azithromycin and clarithromycin) and quinolones (such as ciprofloxacin and levofloxacin). Most commonly, amoxicillin is a reasonable first choice for mild sinus infections, although other antibiotics are becoming more common given drug allergies and infections resistant to amoxicillin. Most cases of acute sinusitis will get better with 10 to 14 days of antibiotics. Longer courses of antibiotics may be needed for chronic sinusitis.

While acute sinus infections usually respond to antibiotics alone, chronic sinus infections are often caused, at least in part, by inflammation in the nasal passages and sinuses. Therefore, other medications are needed to reduce this inflammation so that the infection can drain from the sinuses.

For people with chronic sinus infections, a nasal steroid spray such as Flonase or Nasonex may be recommended to both treat and prevent the recurrence of sinus infections. In cases of more severe inflammation, the use of oral steroids such as prednisone for three to 10 days is often recommended.

Other helpful medications include topical decongestants (such as Afrin) for no more than three days, followed by oral decongestants (such as Sudafed) for the duration of the antibiotic therapy. I also recommend the use of nasal saline irrigation to help to remove the mucus from the nasal passages and sinuses in people with recurrent or chronic sinusitis. Nasal saline irrigation has been shown to reduce the amount of infections and antibiotics needed in people with chronic sinusitis.

In severe cases of sinusitis, especially those that do not respond to the above medical treatments, an ear-nose-throat specialist, or otolaryngologist, can further evaluate and treat people. Some people do require surgery to remove a severe sinus infection, especially those complicated by structural problems or nasal polyps.

Want to keep learning? Find out about nasal saline irrigation, a good treatment for sinus infections and allergy symptoms.

Source:

Slavin RG, Spector SL, Bernstein IL. The Diagnosis and Management of Sinusitis: A Practice Parameter Update. J Allergy Clin Immunol. 2005; S13-47.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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