Treating sinusitis: Don’t rush to antibiotics

| Posted On Feb 27, 2014 | By:

sinusitis painMillions of people are prescribed antibiotics each year for sinusitis, a frequent complication of the common cold, hay fever, and other respiratory allergies. In fact, 15 to 21 percent of all antibiotic prescriptions for adults in outpatient care are for treating sinusitis. Unfortunately, most of those people probably don’t need the drugs. Here’s why:

The drugs usually don’t help.

Sinusitis can be uncomfortable. People with the condition usually have congestion combined with yellow, green, or gray nasal discharge plus pain or pressure around the eyes, cheeks, forehead, or teeth that worsens when they bend over. But sinus infections almost always stem from a viral infection, not a bacterial one—and antibiotics don’t work against viruses. Even when bacteria are responsible, the infections usually clear up on their own in a week or so. And antibiotics don’t help ease allergies, either.

They can pose risks.

About one in four people who take antibiotics have side effects, including stomach problems, dizziness, or rashes. Those problems clear up soon after stopping the drugs, but in rare cases antibiotics can cause severe allergic reactions. Overuse of antibiotics also encourages the growth of bacteria that can’t be controlled easily with drugs. That makes you more vulnerable to antibiotic-resistant infections and undermines the benefits of antibiotics for others

They’re usually a waste of money.

Antibiotics often aren’t very expensive, but any money spent on unnecessary drugs is money down the drain. And since patients often request prescriptions and doctors often comply, the total cost to the health-care system is substantial—at least $31 million a year.

So when are antibiotics necessary?

They’re usually required only when symptoms last longer than a week, start to improve but then worsen again, or are very severe. Worrisome symptoms that can warrant immediate antibiotic treatment include a fever over 101.5°F, extreme pain and tenderness over your sinuses, or signs of a skin infection, such as a hot, red rash that spreads quickly. When you do need antibiotics, the best choice in many cases is generic amoxicillin, which typically costs about $4 and is just as effective as more expensive brand-name antibiotics, such as Augmentin. Note that some doctors recommend CT scans when they suspect sinusitis. But those tests are usually necessary only if you have frequent or chronic sinusitis or you’re considering sinus surgery.

How should you treat sinusitis?

Most people recover from sinusitis caused by colds in about a week, but several self-help steps may bring some relief sooner:

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2013 Consumer Reports. Developed in cooperation with the American Academy of Allergy, Asthma & Immunology. To learn more about the sources used in this report and terms and conditions of use, visit ConsumerHealthChoices.org/about-us/

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Comments

  1. I loved this article. Patient’s often misunderstand what antibiotics are for. This article should be in every waiting room. And when patients are given antibiotic there should be a thourough explination why they are being prescribed.

    Comment by Silva Bellitti on March 4, 2014 at 11:20 am
  2. I have had several prolonged sinus infections and rhinitis in the past. Not once has amoxicillin done anything—my doctors have always had to move to something stronger, which has worked.

    Comment by Louis Stuhl on March 20, 2014 at 10:13 pm
  3. Last June, I was prescribed Clindamycin for a sinus infection. Since I had had a sinus infection off and on for a few months and, the day that I went to the walk-in CVS clinic, I also had a fever, an antibiotic seemed appropriate. But, I now know, that Clindamycin SHOULD NOT have been prescribed to me for a sinus infection. Clindamycin, according to the Mayo Clinic, is at the top of the list of antibiotics that lead people to contract C-diff, which is what happened to me. C-diff is a bacteria that is very, very difficult to get rid of and that destroys virtually all of the good bacteria in one’s intestines. I have been off and on medication since last July (currently, off, and keeping my fingers crossed) to rid my body of C-diff, and I had to wait three months to have non-elective surgery because, as my surgeon explained, one who has C-diff and has surgery can end up having to have a colostomy.

    Comment by Catherine Adamowicz on March 26, 2014 at 12:12 pm

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