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Fact Sheet: Antibiotics and Sinuses
An antibiotic is a soluble substance derived from a mold or
bacterium that inhibits the growth of other microorganisms.
The
first antibiotic was Penicillin, discovered by Alexander Fleming in 1929,
but it was not until World War II that the effectiveness of antibiotics
was acknowledged, and large-scale fermentation processes were developed
for their production. |
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| Acute sinusitis is one of
many medical disorders that can be caused by a bacterial infection. However, it
is important to remember that colds, allergies, and environmental irritants,
which are more common than bacterial sinusitis, can also cause sinus problems.
Antibiotics are effective only against sinus problems caused by a bacterial
infection. The following symptoms may indicate the presence of a
bacterial infection in your sinuses:
- Pain in your cheeks or upper back teeth
- A lot of bright yellow or green drainage from your nose for more than 10
days
- No relief from decongestants, and/or
- Symptoms that get worse instead of better after your cold is gone.
Most patients with a clinical diagnosis of acute sinusitis caused by a
bacterial infection improve without antibiotic treatment. The specialist will
initially offer appropriate doses of analgesics (pain-relievers), antipyretics
(fever reducers), and decongestants. However if symptoms persist, a treatment
consisting of antibiotics may be recommended.
Antibiotic
Treatment
Antibiotics are labeled as narrow-spectrum drugs when
they work against only a few types of bacteria. On the other hand,
broad-spectrum antibiotics are more effective by attacking a wide range of
bacteria, but are more likely to promote antibiotic resistance. For that reason,
your ear, nose, and throat specialist will most likely prescribe narrow-spectrum
antibiotics, which often cost less. He/she may recommend broad-spectrum
antibiotics for infections that do not respond to treatment with narrow-spectrum
drugs.
Acute Sinusitis
In most cases, antibiotics
are prescribed for patients with specific findings of persistent purulent nasal
discharge and facial pain or tenderness who are not improving after seven days
or those with severe symptoms of rhinosinusitis, regardless of duration. On the
basis of clinical trials, amoxicillin, doxycycline, or
trimethoprim-sulfamethoxazole are preferred antibiotics.
Chronic
Sinusitis
Even with a long regimen of antibiotics, chronic
sinusitis symptoms can be difficult to treat. In general, however, treating
chronic sinusitis, such as with antibiotics and decongestants, is similar to
treating acute sinusitis. When antibiotic treatment fails, allergy testing,
desensitization, and/or surgery may be recommended as the most effective means
for treating chronic sinusitis. Research studies suggest that the vast majority
of people who undergo surgery have fewer symptoms and better quality of
life.
Pediatric Sinusitis
Antibiotics that are
unlikely to be effective in children who do not improve with amoxicillin include
trimethoprim-sulfamethoxazole (Bactrim) and erythromycin-sulfisoxazole
(Pediazole), because many bacteria are resistant to these older antibiotics. For
children who do not respond to two courses of traditional antibiotics, the dose
and length of antibiotic treatment is often expanded, or treatment with
intravenous cefotaxime or ceftriaxone and/or a referral to an ENT specialist is
recommended.
© 2004 AAO-HNS/AAO-HNSF
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