For acute, uncomplicated cases, a synthetic penicillin is used most commonly amoxicillin (such as Amoxil, Polymox, or Trimox). This antibiotic is effective against the usual microorganisms and is relatively inexpensive. Amoxicillin's main side effects include allergic reactions (throat swelling, hives) and stomach upset.
People allergic to penicillin can take a sulfur-containing antibiotic called trimethoprim/sulfamethoxazole or TMP/SMX (such as Bactrim, Cotrim, or Septra). This drug is not recommended for people who are allergic to sulfur.
People who have several episodes of partially treated acute sinusitis or those who have chronic sinusitis may become resistant to amoxicillin and TMP/SMX. Newer synthetic penicillins and cephalosporins such as Augmentin, cefuroxime (Ceftin), and loracarbef (Lorabid) can clear most of the resistant organisms that cause sinus infection.
Overuse of these "broader-spectrum" antibiotics may eventually lead to organisms evolving that can resist even the most potent antibiotics currently available. Therefore, simpler antibiotics such as amoxicillin should be used first and taken for the entire duration (14-21 days). The basic rule of thumb is to take the antibiotic until the symptoms disappear, and then continue to take the antibiotic for one more week.
Home remedies that open and hydrate the sinuses may promote drainage. See Self-Care at Home for information on increasing daily fluid intake, inhaling steam, and taking expectorants and pain relievers.
If environmental allergies cause the sinusitis, an antihistamine may help reduce swelling of the mucous membranes. Allergens stimulate white blood cells in the blood and tissues to release histamine into the circulation. This causes fluid to leak from blood vessels into the tissues of the nasal passageways, leading to nasal congestion symptoms.
Some of the older sedating OTC antihistamines are no longer recommended because they tend to dry out and thicken the mucus, making drainage more difficult.
Non-sedating antihistamines such as fexofenadine (Allegra), loratadine (Claritin), or desloratadine (Clarinex) do not seem to dry out the mucosa. If nasal congestion is severe, a decongestant can be added (for example, Allegra-D or Claritin-D).
To treat acute sinusitis, one or more OTC or prescription therapies may be all that is necessary. For those with recurrent bouts of acute sinusitis or chronic sinusitis, the addition of an intranasal steroid may reduce symptoms. Commonly prescribed medications are beclomethasone (Beconase), fluticasone (Flonase), triamcinolone (Nasacort), flunisolide (Nasalide), and Vancenase. Steroids are potent inhibitors of inflammation.
Intranasal steroids (nasal sprays) work directly on the lining of the nasal passages and sinuses with little effect on the rest of the body when taken in prescribed dosages.
As with the other classes of drugs, many intranasal steroids are available. Some are more tolerable than others. These are prescription medications. These drugs do not relieve symptoms immediately like nasal and oral decongestants do, but once therapeutic drug levels are achieved, symptoms usually improve, and decongestants may be unnecessary.
During months when environmental allergens are most widespread, the early administration of intranasal steroids may help to prevent sinusitis and keep the sinuses open and draining.
The surgery is performed endoscopically using the same fiberoptic nasopharyngoscope used to make the diagnosis.
The goal is to remove obstructive mucosal disease, open the sinus nasal passageway, and allow drainage of the sinuses.
During the surgery, nasal polyps can also be removed, and a crooked nasal septum can be straightened, leading to improved airflow. Long-term nasal steroids and periodic antibiotics may still be necessary.
A continuing sinus infection may need further investigation. A culture obtained during a routine office visit or during endoscopic surgery may reveal anaerobes a type of bacteria, which require treatment with broad-spectrum antibiotic drugs, or fungi, which require treatment with antifungal medications.
Blood cells and lining cells of the mucosa in the sinuses can normally fight off foreign invaders. However, when overwhelmed by viruses and bacteria, coupled with a depressed immune system or over-reactivity to allergens, the result is the inflammation associated with sinusitis.
With appropriate therapy, a short-lived infection can be treated effectively. Because foreign substances trigger numerous reactions, many treatments are available that can treat the symptoms of inflammation.
The chief goal of treatment is wiping out bacteria from the sinus cavaties with antibiotics. This helps to prevent complications, relieve symptoms, and reduce the risk of chronic sinusitis.
Home remedies that open and hydrate the sinuses may promote drainage. See Self-Care at Home for information on increasing daily fluid intake, inhaling steam, and taking expectorants and pain relievers.
If environmental allergies cause the sinusitis, an antihistamine may help reduce swelling of the mucous membranes. Allergens stimulate white blood cells in the blood and tissues to release histamine into the circulation. This causes fluid to leak from blood vessels into the tissues of the nasal passageways, leading to nasal congestion symptoms.
To treat acute sinusitis, one or more OTC or prescription therapies may be all that is necessary. For those with recurrent bouts of acute sinusitis or chronic sinusitis, the addition of an intranasal steroid may reduce symptoms. Commonly prescribed medications are beclomethasone (Beconase), fluticasone (Flonase), triamcinolone (Nasacort), flunisolide (Nasalide), and Vancenase.
Sinus infection, or sinusitis, is an inflammation of the sinuses and nasal passages. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. A person with a sinus infection may also have a cough, a fever, bad breath, and nasal congestion with thick nasal secretions. Sinusitis is categorized as acute (sudden onset) or chronic (long term, the most common type).
Anatomy of the sinuses (also called paranasal sinuses): The human skull contains four major pairs of hollow air-filled cavities called sinuses. These are connected to the space between the nostrils and the nasal passage. Sinuses help insulate the skull, reduce its weight, and allow the voice to resonate within it.
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