Health Team

Most sinus infections don't require antibiotics, new guidelines say

Posted March 27, 2012
Updated April 3, 2012

— New guidelines released by the Infectious Diseases Society of America say that most sinus infections do not require antibiotics. They recommend prescribing antibiotics only if the case is severe or if symptoms have lasted for 10 or more days.

For patients that have very severe symptoms for three to four days with a high fever, they recommend immediate or quick treatment with antibiotics…usually with a stronger antibiotic," said Dr. Linda Dahl of Lenox Hill Hospital in New York.

About 1 in 7 people suffer from sinus infections every year, and most are prescribed an antibiotic to relieve congestion. However, antibiotics only fight bacterial infections, and viruses cause 90 to 98 percent of sinus infections.

It is difficult to determine whether an infection is bacterial or viral, and some doctors prescribe antibiotics, such as Amoxicillin, just in case. Physicians say the practice is leading to drug-resistant strains of bacteria.

"The types of antibiotics we can offer, the range is more narrow now, because the antibiotics that used to be offered, like the Z-pac or Amoxicillin, just aren't really effective anymore," said Dahl.

Physicians recommend over-the-counter decongestants to keep sinuses clear, as well as washing hands often to prevent the spread of germs.


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  • happymom Apr 3, 2012

    I rarely get a sinus infection, but when I do antibiotics are a must. The few times I haven't had them, the infection becomes bronchitis or pneumonia as it travels through my respiratory system. The only problem I have with advice like this is that doctors tend to either over-prescribe or under-prescribe. My worst infections came when I couldn't convince the doctor that I really did need an antibiotic.

    As far as the "Obama-care" link... first, these are studies that are reported. I seriously doubt Obama is sitting around calling researchers (who stake their livelihoods and reputations on the results they report) in order to reduce the number of antibiotics used. And for what reason?

    Secondly, healthcare rationing has been around in this country for over 30 years in many states. NC's major services are rationed (ever hear of Certificate of Need laws?). The "rationing" argument makes no sense on its face when you understand how healthcare actually works in this country.

  • OpenM1nd Apr 2, 2012

    Try inhaling a mild saline solution sold OTC. It's inexpensive, safe, non-medicated, not habit-forming, and kills germs while helping to flush out congestion. I've been doing that for years and have had no sinus infections since my doctor recommended it in the late 90's. This technique also helps to prevent chronic nosebleeds.

  • Elvisisdead Mar 30, 2012

    Anyone who would seriously try to connect this to President Obama needs to take off their political blinders and try thinking about what they are saying before they post such nonsense.

  • grimreaper Mar 30, 2012

    Well, a viral infection of the sinus is not going to generally kill you (but it if it was there is nothing at all you can do about it anyway) however, a bacterial one sure will...I would not risk skipping taking antibiotics for a sinus infection. Based on family members, I would say I have witnessed exactly ZERO sinus infections that did not go away after antibiotics...

  • DeerHeart Mar 28, 2012

    Antibiotics have always been and will continue to be prescribed when they are not necessarily indicated according to research, texts,etc. Whether its a placebo effect, combating opportunistic infections as previously mentioned, or anti-inflammatory effects----they help in many ways. I suspect it will take just a few lawsuits where antibiotics were not prescribed for guidelines to be changed or largely ignored. Ya Heard.

  • Wheelman Mar 28, 2012

    Most sinus infections are the result of irritated sinus tissues due to the dry air from indoor heat and A/C or allergic reaction to dust, pollen, etc. The tissues become irritated and dry and then deveolop tiny cracks that allow the viruses or bacteria a breeding ground. I had severe problems for years until I started using over the counter non-addictive products to help protect my sinuses. Some people use a saline nasal spray, some use a "neti-pot" to flush them. I use a product called NasalCrom every morning. A couple of quick sprays in each nostril takes care of it. You have to use it for a few days before it starts to work and you have to use it on a regular basis for it to continue. I used to have 3-5 major infections a year and have had to have my sinuses flushed several times in the past. Many work days missed. In the last 18 years I have been using this I have had 1 minor sinus infection and no colds. I love this stuff! It's not cheap, but worth every penny. CVS has a generic.

  • laurenfedorov Mar 28, 2012

    Antibiotics are used to counter secondary bacterial infections, some of which tend to be opportunistic in nature, meaning that they take advantage of the already weakened immune system and cause additional infection. Secondary infections are often a concern with viral infections, and that is where the antibiotics come in. They are not designed to fight viral infections.

  • laurenfedorov Mar 28, 2012

    Stop shorting cocaine, bath salts and whatever else and see if your sinus infections don't go away!

    Contrary to what you appear to believe, not all sinus infections are caused by snorting things. My mom is prone to these, and she does not snort cocaine or anything else. Some people are simply prone to them, and it does not mean that they snort anything. I suggest you do a little more research before making such comments.

  • pmck Mar 28, 2012

    Many sinus infections are fungal. You don't know unless your doctor checks you. Most people stop having the infections when they start using sinus wash to keep the irritants/bacteria/fungus/virus flushed out.
    I agree with hollylama - what is up with our (manufactured) weather?

  • yy_heart Mar 28, 2012

    yes, a virus causes the infection in that the virus causes everything to get stopped up and trapped in your sinuses. it is, however, the bacteria that also get trapped and therefore multiply in one place instead of draining out like normal that cause the actual infection and issues.

    an antibiotic is not needed if you can get to the blockage fast enough to drain it before the bacterial infection starts. it is needed though if the blockage has been there long enough.