Sinusitis. Do you need antibiotics?

Antibiotics are now being used less often to treat infected sinuses (sinusitis). Recent research has shown that antibiotics only work in 1 in 15 cases. The sinuses are air-filled spaces in the bones of the face, behind the cheeks, forehead and eyes. They are connected to the nose via narrow openings. An infection in the nose from a head cold can block these openings, causing a build-up of pressure and infection in the sinuses nearby.

Symptoms of sinusitis include:

  • Pressure or pain in the face or upper teeth
  • Blocked nose
  • Yellow or green mucus from the nose
  • Headache, fever, tiredness

When are antibiotics needed?

Most sinus infections are caused by a virus and get better without antibiotics within 14 days. In some cases, antibiotics can shorten the illness from bacterial infection, but it can be hard to know which cases will benefit.

Often the risks of antibiotics outweigh the small benefits. Antibiotic treatment can cause diarrhoea, thrush and rashes. Unnecessary use of antibiotics increases resistance so they don’t work so well next time. As a result, many doctors prefer not to use antibiotics initially, except in more severe or persistent cases.

What else you can do?

Spraying salt water from a saline spray bottle helps clear the passages. Steam inhalations for 10 minutes twice daily are also helpful.

Decongestant tables can reduce swelling but antihistamines are of less use. Decongestant nose sprays should be stopped after 5 days to avoid rebound swelling.

Drink extra fluids and take paracetamol for pain. See your Doctor.

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