Sinusitis is often caused by viruses which are not killed with antibiotics; even if sinusitis is caused by bacterial germs that antibiotics can kill, antibiotics are often not required
Treatment of sinusitis includes the following:
- using Acetaminophen (Tylenol) or Ibuprofen (Advil or Motrin) or Naproxen (Aleve) for fever or pain
- using salt water nose sprays (many trade names are available at pharmacies) or a Neti pot or a similar irrigation system to cleanse the nose
- using these types of devices 5 times daily can cure a sinus infection, even if caused by a bacteria, without the need for an antibiotic
- If a salt water spray is used, the spay should be instilled into each nostril, followed by blowing the nose to eradicate the mucous and pus
- cortisone nose sprays that help shrink the swelling of the nasal tissues may be helpful these are now available without a prescription and your pharmacist can provide you with options. If you do use the cortisone nose spray, it should be used after you’ve cleaned the nasal tissue with the salt water.
Decongestants may also offer benefit from facial pain and nasal congestion. Options such as Dristan and Otrivin are available, but they should not be used for more than 5 days because longer use can lead to rebound worsening nasal congestion (rhinitis medicamentosa). Oral decongestants such as Sudafed contain either pseudoephedrine or phenylephrine, and pharmacies often carry their own lower cost brands. Oral decongestants may have an adrenaline-like effect causing alertness and wakefulness and thus should be avoided at bedtime.
If your blood pressure is poorly controlled, oral decongestants may make your blood pressure rise and thus should be used with caution. If you don’t suffer from allergies, antihistamines are not indicated and in some cases may be counter-productive. If, despite the above measures, you have to clear coloured pus-like secretions from your nose for longer than a week or you have had a fever of 38 degrees C for more than 3 days, antibiotics may be of benefit and you should inform our office of these issues.