A majority of sinus infections are caused by viruses, and hence taking antibiotics to treat this medical condition does not seem prudent. The following article discusses the need for a shorter duration of antibiotic treatment for sinus infections.
Did You Know?
Longer courses of antibiotics increase the risk of generating drug-resistant bugs.
Suffering from a sinus infection? Well, in most cases the advice that you will get from your doctor and family members is to take antibiotics to get relief. Antibiotics have long been the first line of treatment for sinusitis. Popping antibiotics has been commonly used to relieve the symptoms of a sinus infection. However, new guidelines released by the Infectious Diseases Society of America (IDSA), emphasize a more cautious approach before recommending antibiotics for sinus infections.
The IDSA suggests a wait and watch approach when it comes to treating sinus infections. Sinusitis can also be caused by viruses, fungi, and even exposure to air pollutants. The IDSA discourages patients from taking medications on a self-prescription basis, and warns doctors against frequently prescribing antibiotics. The guidelines set by experts from the IDSA have been formulated to curb the rampant use of antibiotics for the treatment of sinus infections.
The IDSA has notified that majority of sinus infections are caused by viruses, hence indiscriminate use of antibiotics for sinusitis is a primary factor for the increasing presence of drug-resistant bugs. The sheer volume of antibiotics recommended without diagnosing the underlying cause of sinus infections is a cause for concern, which is actually contributing to the rising cases of super bugs that show resistance to multiple drugs.
Diagnostic tests that reveal the type of sinus infection are cumbersome and time-consuming. Hence, doctors often skip these medical tests and prefer to prescribe antibiotics. However, in case the infection is caused by a virus, taking antibiotics is least effective. All this has led to unnecessary use of antibiotics, thereby increasing the risk of drug resistance and unwanted side effects.
According to the Infectious Diseases Society of America (IDSA), viruses account for 90% to 98% cases of all sinus infections, indicating the urgent need to change the perception that antibiotics is the solution for sinus infections. Also, as per the findings of the American Academy of Allergy, Asthma, and Immunology (AAAAI), it is observed that around 60% – 70% cases of sinusitis clear without using antibiotics.
In 2012, the February edition of the Journal of the American Medical Association reported one study that examined the impact of antibiotics in the treatment of sinus infection. Researchers found that out of 166 patients, those put on antibiotics did not experience any significant relief from their counterparts who were taking a placebo.
Another study reported in Mayo Clinic Proceedings, a reputed scientific publication, found out that fungi play a key role in the development of chronic sinusitis. According to the study, proliferation of fungus in the sinus cavities is the most common cause, accounting for 85% cases of chronic sinusitis. The study suggests that though superficially it occurs that bacteria are responsible for chronic sinusitis, the underlying cause is fungal in nature.
Taking antibiotics also kills the ‘friendly’ bacteria that are known to keep fungal growth in check. As a result, antibiotics may actually contribute in spreading fungus, thereby giving an opportunity for harmful bacteria to thrive. Hence, unnecessary usage of antibiotics has to be avoided and preferably a short-term antibiotic course should be used to treat the infection.
In case the sinus infection is bacterial in nature, the IDSA panel advises certain guidelines regarding the medication and the duration of treatment.
IDSA officials suggest that patients need to avoid usage of amoxicillin, as quite a few strains of bacteria have become amoxicillin-resistant. The IDSA suggests using amoxicillin-clavulanate because this is found to be extremely effective in destroying bacteria. Many doctors consider amoxicillin-clavulanate as a solution to the growing menace of bacterial antibiotic resistance. The IDSA panel also urges to stop the usage of commonly prescribed antibiotics like clarithromycin, azithromycin, and trimethoprim as they are no longer found to be effective in treating sinus infections.
The recommendations issued by the IDSA also mention avoiding antihistamines and decongestants during sinusitis, as they can worsen the infection. Antihistamines like Benadryl tend to make the mucus more sticky and thick, in turn aggravating sinus trouble.
However, inhaling nasal steroids (spray or drops) may help to relieve congestion associated with sinus infections. In order to relieve sinus discomfort (pain around the face), the IDSA guidelines recommend using acetaminophen. Increasing fluid intake can also help to flush off the infection.
The IDSA advocates the use of saline irrigation because this therapy is found to improve symptoms and reduce dependence on medications. Salt water solution is used to rinse the nasal passages, which works to liquefy and drain the mucus.
The IDSA has reduced the duration of treatment for adults to lower the risk of drug resistance. Instead of the usual 10 days to 2 week treatment period, the length of the antibiotic course should not last more than a week (5 – 7 days).
The IDSA panel has also come with certain guidelines to recognize bacterial infections. In case the symptoms persist for over 10 days, or the symptoms are severe for 3 – 4 days, followed by high fever (102 – 104 degree Fahrenheit), headache, and thick nasal discharge, the infection is most probably bacterial in nature and demands immediate antibiotic treatment.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical professional.