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What is the best antiobiotic used for sinusitis?
sinusitis
- Thread starter monet
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Many are not even caused by bacteria, so no antibiotic. Most sinusitises are either from allergies or viruses. If it is known to be caused by a bacteria, then the best antibiotic would be one that that specific bacterium doesn't have a resistance to (yet). Sometimes antibiotics are prescribed prophylactically to patients with immune depression to prevent opportunistic infections, otherwise there's generally no reason to prescribe them.
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If it's known to be bacterial, the standard treatment is usually amoxicillin, or Augmentin (amox/clavulanate) for resistant strains. However, this is modified in cases that grow out unusual or highly resistant bugs.
Cheers,
doepug
Cheers,
doepug
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don't be so fast to NOT give Abx. If the patient has a fever or severe sinus pain, you should not wait to give Abx. You wouldn't believe how fast bugs in the sinuses can travel to the CNS.
If treating, Augmentin or Zithromax is first line.
If treating, Augmentin or Zithromax is first line.
D
deleted6669
a friend of mine who is an I.D. doc says anyone with an intact immune system doesn't need abx for sinusitis unless they are systemically ill with high fever, elevated white count etc...
most pts with " sinusitis"= runny nose x 2 days with congestion in the er at 3 am on a saturday actually have a viral uri.
most pts with " sinusitis"= runny nose x 2 days with congestion in the er at 3 am on a saturday actually have a viral uri.
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I seem to remember that even if abx are indicated, the duration of treatment is something like 30 days due to the abx's poor permeability into the sinuses. But don't quote me on this... 
One must ask one's self; how likely is the patient to take the abx for 30 days? I'm going with "not very", hence further diminishing any likely benefit from the abx...
One must ask one's self; how likely is the patient to take the abx for 30 days? I'm going with "not very", hence further diminishing any likely benefit from the abx...
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Believe me, if you're a chronic sinusitis sufferer, you're going to take the abx as long as it takes to get rid of them. And if you don't, your significant other will see to it. Sinus breath is no joke.
I once had to take them for six weeks. Now my allergies are under better control and I haven't had a sinus infection in ... a long time. Knock wood. Knock some more. Knock the wood really hard.
Also note that migraines can be misdiagnosed as sinusitis, though, something that happened to me in my twenties.
I once had to take them for six weeks. Now my allergies are under better control and I haven't had a sinus infection in ... a long time. Knock wood. Knock some more. Knock the wood really hard.
Also note that migraines can be misdiagnosed as sinusitis, though, something that happened to me in my twenties.
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What would be a reason that a person has recurrent sinusitis and tonsilitis as an adult (when never having the problems as a child/teen)? At what point would one recommend an adult having tonsils removed? 2-3 instances of tonsilitis/year?
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AS a sufferer of chronic sinusitis since 11th grade of high school (im now an MS1), Id like to point out a few things from my personal experience:
The image portrayed of "pt with sinusitis often has had a cold for only a few days" is garbage. I personally will never see a doc unless i've been severly congested for atleast 10d.
Antibiotics HAVE significantly helped me through my incidents, which occur >4/yr. I've seen an allergist and have been on allegra and flonase for several years, it has helped to reduce the frequency. I've been CTd by an ENT for possible FESS, and am not a candidate because my ostia are normal and there is not significant scar tissue in any of my sinuses (my maxillary sinuses are the ones most often implicated). The ENT did remove my adenoids, which were abnormally enlarged, this past summer. But i've had one case of sinusitis since then, so it might reduce the freq. but it certainly hasn't removed the problem.
I think anyone who has said that Abs are only for extreme cases with high fever needs to reconsider, as I don't even present with fever during sinusitis, and until you know the chronic pain associated with it you shouldnt be so quick to judge. So far it has been the ONLY effective treatment for me.
The image portrayed of "pt with sinusitis often has had a cold for only a few days" is garbage. I personally will never see a doc unless i've been severly congested for atleast 10d.
Antibiotics HAVE significantly helped me through my incidents, which occur >4/yr. I've seen an allergist and have been on allegra and flonase for several years, it has helped to reduce the frequency. I've been CTd by an ENT for possible FESS, and am not a candidate because my ostia are normal and there is not significant scar tissue in any of my sinuses (my maxillary sinuses are the ones most often implicated). The ENT did remove my adenoids, which were abnormally enlarged, this past summer. But i've had one case of sinusitis since then, so it might reduce the freq. but it certainly hasn't removed the problem.
I think anyone who has said that Abs are only for extreme cases with high fever needs to reconsider, as I don't even present with fever during sinusitis, and until you know the chronic pain associated with it you shouldnt be so quick to judge. So far it has been the ONLY effective treatment for me.
D
deleted6669
I think many of us are jaded because we see many er pts with runny nose x 2 hrs wanting abx and they haven't tried anything otc yet.
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I'm not saying this isnt the case, but trust me, ive had many a new doctor look at me with scrutiny when i say "chronic sinusitis sufferer"
There should be a way to keep validated medical records on you to present to your physician
There should be a way to keep validated medical records on you to present to your physician
