Antibiotics for sinus infection – Which one to take? How effective are these pills at getting rid of the sinusitis symptoms? We will the answer those questions in this article, but before answering that question, let’s first define sinus infection.
Sinus infection is an inflammation of paranasal sinuses caused by bacteria, viruses and allergies. Paranasal sinuses are the air cavities within the passages of the nose, infection and inflammation of these cavities produce symptoms such as sinus headache, heaviness in the paranasal sinuses, facial tenderness, nasal stuffiness, post nasal dripping, sore throat, fever, and thick greenish nasal discharge with or without pus and/or blood. Based on the duration of the symptoms sinusitis can be classified into acute, sub-acute or chronic. Acute sinusitis lasts for less than 4weeks, sub-acute sinusitis lasts for 4 to 8 weeks, and chronic sinusitis continues for 8 weeks or more.
Viral sinus infections will get resolved in ten days without antibiotics, and sinus infections caused by allergies can be treated with anti-allergic medications. Vast majority of sinus infections are caused by bacteria. Therefore, antibiotic therapy is the main stay of medical treatment in sinus infection. Choice of antibiotics depends on the severity of the sinus infection, whether the sinusitis is acute, sub-acute or chronic.
Antibiotics for sinus infection are used in bacterial infections which involve frontal, ethmoid, or sphenoid sinuses, because such type of sinusitis are more prone to complications. Pain in the paranasal sinuses, facial pain, pus like nasal discharge and symptoms lasting for more than a week indicate bacterial infection. Five most common bacteria which can cause sinus infection include Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes.
Antibiotics for sinus infection are effective at fighting bacterial sinus infections NOT viral sinus infections
The antibiotics which are effective in the treatment of sinus infection must be able to kill all these bacterial types. Amoxicillin is a reasonable antibiotic to use as a first line of treatment in sinusitis. But, most physicians prefer to use Amoxicillin with Clavulanate [Augmentin] because of its broad spectrum action against most of the species and strains of bacteria that cause sinus infection.
Amoxicillin is a synthetic penicillin, in penicillin allergic patients Cefaclor, Loracarbef, Azithromycin, Sulphamethoxazole, Trimethoprim and other antibiotics can be used as first line of treatment. In patients who are allergic amoxicillin, fluoroquinolones and macrolide antibiotics such as clarithromyicin, tetracycline and doxycycline can be used. If the sinus infection does not subside in 5 days with amoxicillin alone, the patient may be switched to Augmentin [Amoxicillin+Clavulanate]. In the treatment of sinus infection, effective antibiotics should be continued for 10 to 14 days. In some cases, it is not unusual to continue antibiotic therapy for 14 to 21 days.
Antibiotics for sinus infection regiment can last up to 21 days (3 weeks)
Patients who have several episodes of partially treated acute or chronic sinusitis may develop resistance to Amoxicillin. In such cases, new synthetic penicillins and cephalosporins such as Cefuroxime and Loracarbef can clear the resistant organisms. A regimen of Amoxicillin 500mg three times a day for 10 to 14 days is recommended as first line of treatment. A single dose of 2 grams of extended-release azithromycin extended may be more effective than 10 to 14 days course of Amoxicillin or Augmentin. However, azithromycin is not a good choice in sinusitis because symptoms improve due to its anti-inflammatory effects and it has poor efficacy against H Infuenzae and S Pneumoniae.
Antibiotics for sinus infection should be used cautiously, if they are overused, organisms may become resistant to most potent antibiotics currently available. Therefore, simpler antibiotics such as Amoxicillin should be used as first line of treatment for entire duration [14 to 21 days].