In an attempt to preserve the effectiveness of antibiotics and to provide better treatment to patients, experts now recommend doctors drastically cut back on prescribing antibiotics for sinus infections.
"Overuse of antibiotics, especially if inappropriate, leads to the emergence of superbugs and drug resistance, which sets up a vicious cycle leading to the use of more potent and broad-spectrum antibiotics," explains Anthony W. Chow, MD, professor emeritus of infectious diseases at the University of British Columbia in Vancouver. "Inappropriate antibiotics also lead to unnecessary adverse effects and add to the cost of healthcare."
Sinus infections most often occur when people are getting over a cold or other respiratory infection, but environmental contaminants and seasonal allergies can also lead to the uncomfortable facial pressure associated with these infections.
Roughly 15 percent of the population suffers from at least one sinus infection a year. Although more than 90 percent of cases are caused by a virus—meaning antibiotics will do nothing to treat the infection—doctors often write out prescriptions for antibiotics. In fact, sinus infections are the fifth-leading cause of prescribing antibiotics, despite the fact that only about 2 percent of cases can be effectively treated with the drugs.
In the rare case that a sinus infection is caused by bacteria, the guidelines, issued by an Infectious Diseases Society of America panel chaired by Dr. Chow, recommend that doctors prescribe amoxicillin containing clavulanate, an enzyme-inhibitor that helps overcome antibiotic resistance. Doctors should avoid prescribing azithromycin and clarithromycin because there are growing drug-resistance problems with those antibiotics.
How to deal with a sinus infection:
• Gauge symptoms. Most people don't need to see a doctor for a sinus infection. However, Dr. Chow outlines the symptoms of a bacterial sinus infection that does warrant prompt attention and possibly antibiotics:
1. Symptoms that last for 10 or more days and are not improving, or severe symptoms accompanied by a fever of 102 degrees or higher
2. Facial pain and green nasal discharge that lasts for 3 or 4 days
3. Double sickening—symptoms that seem to improve after 5 to 7 days, but then return and worsen.
There are exceptions to these rules, though. Very young or old patients, or people with underlying medical issues like cancer, diabetes, chronic heart, lung, or kidney ailments, or people who have recently been hospitalized should see a doctor when symptoms first surface, since they are more susceptible to infection, Dr. Chow notes.
• Reach for the Neti. Nasal irrigation sprays, drops, or liquids using a sterile solution can help relieve symptoms, although children may not cooperate with the treatment.
• Avoid certain over-the-counter meds. Decongestants and antihistamines don't help alleviate bacterial or viral sinus infections and could actually make symptoms worse.
• Evict sinus irritators in the home. Avoid air fresheners, scented candles, and gel plug-ins. The fragrance chemicals they contain can aggravate allergies, which could in turn spark a sinus infection.