Anthony Chow, professor emeritus of infectious diseases at the University of British Columbia, Vancouver and chairman of the guidelines panel.
A study of people with sinus infections published in February in the Journal of the American Medical association showed that those who took antibiotics saw no better improvement in their symptoms than those taking a placebo. The new guidelines provide specific characteristics of the illness to help doctors distinguish between viral and bacterial sinus infections. A sinus infection, properly called acute rhinosinusitis , is inflammation of the nasal and sinus passages that can cause uncomfortable pressure on either side of the nose, and last for weeks.
Most sinus infections develop during or after a cold or other upper respiratory infection, but other factors such as allergens and environmental irritants may play a role. According to the guidelines, a sinus infection is likely caused by bacteria, and should be treated with antibiotics, if any of these criteria are met:. The guidelines recommend treating bacterial sinus infections with amoxicillin-clavulanate, instead of the drug currently used, amoxicillin, because the addition of clavulanate helps to thwart the development of antibiotic resistance.
The guidelines also recommend against using other commonly used antibiotics, due to increasing drug resistance.
Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Sinusitis: Should I Take Antibiotics? Get the facts. Your options Take antibiotics to treat sinusitis. Don't take antibiotics. Try other medicines and home treatment instead. Key points to remember Sinusitis is an infection or inflammation of the lining of the sinuses.
Sinusitis usually goes away on its own. Sinusitis is usually caused by a virus , so antibiotics won't help. Antibiotics do work if sinusitis is caused by bacteria. But you may not need to take them. Most people get better even if they don't take antibiotics.
Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance. Antibiotics have side effects. The most common ones include upset stomach, diarrhea, and belly pain. Antibiotics can also lead to vaginal yeast infections.
What is sinusitis? There are two types of sinusitis: Acute short-term. Acute sinusitis is usually caused by a virus. It can last for 2 to 4 weeks. Symptoms often start to clear up on their own in 10 to 14 days.
Chronic long-term. Chronic sinusitis is usually caused by bacteria. Sometimes it is caused by a fungus. It can last for 12 weeks or longer and can be hard to treat. How is sinusitis treated? Medicines that are used most often include: Decongestants , such as Sudafed, that are taken as pills or liquids. These can reduce swelling and improve sinus drainage.
Over-the-counter pain medicine , such acetaminophen for example, Tylenol or ibuprofen for example, Advil. Antibiotics , which kill bacteria.
Antibiotics will only work if your sinusitis is caused by bacteria. How do you know if your sinusitis is caused by bacteria? You may have a bacterial infection in your sinuses if: You have pain in your cheeks or upper back teeth and a high fever that doesn't go away.
You have a lot of bright yellow or green drainage from your nose for more than 10 days. Decongestants do not relieve your pain. Your symptoms get worse instead of better after your cold is gone. How well do antibiotics work for sinusitis? What are the risks of antibiotics? Common but mild side effects of antibiotics include: Upset stomach. Belly pain. Vaginal yeast infections. How can you treat sinusitis without antibiotics? Here are some things you can do: Drink plenty of fluids to thin your mucus.
Apply moist heat using a hot, damp towel or gel pack to your face for 5 to 10 minutes. Do this at least 3 times a day. Breathe warm, moist air from a steamy shower, a hot bath, or a sink filled with hot water. Use saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria. You can buy saline nose drops or sprays at a pharmacy or make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled.
You may also find it helpful to gargle with warm salt water. Ask your doctor if you can take over-the-counter medicines such as pain relievers and decongestants to help you feel better. Be safe with medicines. Read and follow all instructions on the label. If you need to blow your nose, do it gently. Blowing your nose too hard may force thick mucus back into your sinuses. Keep both nostrils open when you blow your nose.
Why might your doctor recommend antibiotics for sinusitis? You doctor may recommend antibiotics if: You have symptoms of a bacterial infection and you have not gotten better after 10 days, even with home treatment.
Your symptoms are severe, or you have other problems, such as pus forming in your sinus cavities. You have had sinusitis for 12 weeks or longer chronic sinusitis. Compare your options. Compare Option 1 Take antibiotics to treat sinusitis Don't take antibiotics. It's best to completely avoid alcohol while taking metronidazole or tinidazole, and for 48 hours afterwards, as this combination can cause very unpleasant side effects, such as:.
It's recommended that you do not drink alcohol while taking antibiotics in general. However, as long as you drink in moderation, alcohol is unlikely to interact significantly with your medicine.
Read more about drinking alcohol while taking antibiotics. Some antibiotics, such as rifampicin and rifabutin, can reduce the effectiveness of the contraceptive pill. If you're prescribed rifampicin or rifabutin, you may need to use additional contraception, such as condoms, while taking antibiotics. Speak to your GP, nurse or pharmacist for advice.
Some of the medicines you may need to avoid, or seek advice on, while taking an antibiotic include:. It's usually recommended that you avoid taking penicillin at the same time as methotrexate, which is used to treat psoriasis , rheumatoid arthritis and some forms of cancer.
This is because combining the 2 medications can cause a range of unpleasant and sometimes serious side effects. However, some forms of penicillin, such as amoxicillin , can be used in combination with methotrexate. You may experience a skin rash if you take penicillin and allopurinol, which is used to treat gout.
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