Sinusitis: Medications

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Medications

Medications may be needed when symptoms of sinusitis are severe or do not improve. The goals of treatment with medication are to:

• Treat the infection, which is usually caused by bacteria if your symptoms have lasted more than 7 to 10 days.
• Relieve pressure and pain caused by poor sinus drainage.
• Reduce inflammation of the nose and sinuses caused by allergies.

Antibiotic treatment is successful in 90% of cases of short-term (acute) sinusitis when it is caused by bacteria.⁴ You should notice improvement within 3 to 4 days after you begin taking an antibiotic. The number of days you take antibiotics depends on the antibiotic and the severity of the infection. It takes weeks and sometimes months for the mucous membranes that line the sinuses to fully heal after an infection, so some minor symptoms may continue during this time. You are more likely to develop another sinus infection while the membrane is still healing.

Chronic sinusitis may last 3 to 8 weeks or longer and usually requires 3 to 4 weeks of antibiotic treatment. Symptoms may persist or return despite adequate antibiotic treatment. A different antibiotic may be needed to treat the infection. Referral to an ear, nose, and throat (ENT) specialist (also called an otolaryngologist) may be needed if symptoms of sinusitis do not go away despite long-term antibiotic treatment.

Medication Choices

Medications are used and sometimes combined to treat sinusitis.

• Antibiotics kill bacteria. A few examples of antibiotics used are amoxicillin (Amoxil, Larotid, Trimox) and cefdinir (Omnicef).
• Decongestants reduce the swelling of the mucous membranes in the nose. Some examples may include oxymetazoline hydrochloride (Afrin) and phenylephrine hydrochloride (Neo-Synephrine, Sinex Decongestant Nasal Spray).
• Analgesics, such as aspirin, acetaminophen or ibuprofen, are used to relieve pain.
• Corticosteroids, such as beclomethasone dipropionate (Beconase, Vancenase) or prednisone, reduce inflammation in the nasal passages and may be given as an inhaled nasal spray.
• Mucolytics, such as guaifenesin (Robitussin), are used to thin the mucus.

What To Think About

If you are taking antibiotics for a sinus infection, do not stop taking the antibiotics early just because you feel better. Take the entire course of antibiotics. The infection may not go away if you do not take all of the antibiotics prescribed by your health professional.

More powerful antibiotics may be needed to kill bacteria that persist if there is no improvement after trying a first-line antibiotic. Stronger antibiotics can be very costly and may have more side effects.

Fungal sinusitis, which accounts for a significant number of chronic sinusitis cases, does not respond to antibiotic treatment. It may need treatment with antifungal medications, corticosteroids, and surgery.

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Last updated:	August 22, 2006
Author:	Debby Golonka, MPH
Reviewed By:	Kathleen Romito, MD - Family Medicine, Charles M. Myer, III, MD - Otolaryngology
Editors:	Susan Van Houten, RN, BSN, MBA, Terrina Vail