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Do I Need an Antibiotic for Sinusitis?

By Nicole Long
Updated May 17, 2024
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Those suffering from sinusitis, an inflammation of the sinus cavities and nasal passages, often seek treatment from a physician. Treatment will depend on the type of sinusitis and the severity of the sinus infection. Taking an antibiotic for sinusitis is one treatment option, though it is not effective nor recommended in all cases of sinusitis.

Sinusitis is typically categorized into two distinct categories, acute and chronic. Acute sinusitis typically lasts less than eight weeks and doesn’t occur more than three times each year. Chronic sinusitis occurs more frequently, often occurring more than four times each year for a period of at least 20 days for each occurrence, or lasts longer than eight weeks.

The decision to use an antibiotic for sinusitis is based on the type of sinusitis a patient is diagnosed with. For acute sinusitis, antibiotics are not typically prescribed unless certain conditions are met. Those suffering from chronic sinusitis may benefit from the use of an antibiotic for sinusitis.

With acute sinusitis, a wait and see approach may be necessary. At home treatment options, such as nasal irrigation, antihistamines, and decongestants can help relieve symptoms associated with the sinus infection. Those with mild to moderate symptoms don’t typically require antibiotics during the first seven days of treatment. If symptoms worsen and infection persists, a physician may prescribe an antibiotic for sinusitis to help prevent the development of chronic sinusitis. Amoxicillin is the antibiotic of choice in cases of acute sinusitis.

Those diagnosed with chronic sinusitis stand to benefit from the use of an antibiotic for sinusitis. Treatment for chronic sinusitis may require a longer regimen of antibiotics and different types of antibiotics. For instance, while amoxicillin may be prescribed for some with chronic sinusitis, other antibiotics such as clarithromycin or azithromycin may be needed if the infection persists for longer than 28 days.

Developing a resistance to antibiotics is the concern with prescribing antibiotics on a routine basis. Since many acute sinusitis attacks clear up within two weeks, some physicians will wait before choosing to prescribe antibiotics. This is the case in children with sinus infections as well, as antibiotics don’t always reduce the length of the infection.

Allergies are often another obstacle when deciding to use antibiotics for sinusitis. Typically, sinusitis seen in conjunction with allergies is non-bacterial. In this case, antibiotics will not be beneficial. Treatment is aimed at reducing inflammation with anti-inflammatory medications and sprays.

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