The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Use of Antibiotics for Sinusitis

Cases of acute sinusitis usually get better on their own, without the use of antibiotics. In fact, studies have shown that antibiotics are not effective in treating acute sinusitis. *

However, in some cases, your doctor may prescribe an antibiotic to kill the bacteria that cause sinusitis. If you are given an antibiotic, you’ll need to take it for 10-14 days, or longer if you have chronic sinusitis. Even if you begin to feel better, take all of the drugs that your doctor has prescribed.

There are many types of antibiotics available for the treatment of sinusitis. In cases of acute sinusitis, amoxicillin or trimethoprim-sulfamethoxazole is usually tried first because they are cost effective. If you're allergic to either drug, cephalosporin (eg, cefuroxime) or a macrolide antibiotic (clarithromycin, azithromycin) is used.

If there is no symptomatic improvement after one week, a stronger antibiotic is used, such as amoxicillin-clavulanate, quinolone (eg, ciprofloxacin), or cephalosporin (eg, cefuroxime). After 3-4 weeks without a response, clindamycin or metronidazole is added. Oral or nasal decongestants may be added to allow drainage of the sinuses. If antibiotics fail to bring about improvement, you may be hospitalized and given intravenous antibiotics, which is usually accompanied by surgical drainage.

In cases of chronic or recurrent sinusitis, your doctor may do an endoscopic procedure to drain the obstructed sinuses and remove a sample of tissue for testing. Based on the results of this testing, your doctor can prescribe an appropriate antibiotic for you.

Prescription Medications

Beta-lactam Antibiotics

Common names include:

Possible side effects include:

  • Allergic reactions, such as rash, itchy skin, difficulty breathing—Get help if any of these occurs. For breathing difficulties, get emergency care.
  • Diarrhea —This may be severe; in which case, call your doctor.
  • Nausea, vomiting, stomach upset
  • Decreased effectiveness of oral contraceptives—Use another form of contraception while you are taking these medications.
  • Bleeding problems—Check with your doctor if you notice easy bruising, increased bleeding, or spontaneous bleeding.

Fluoroquinolone Antibiotics

Common names include:

These drugs may interact with antacids or sucralfate. Don’t take these medicines within two hours of each other.

Check with your doctor before taking:

  • Levofloxacin with medications for your heartbeat
  • Enoxacin with caffeinated products

Take these medications with a full glass of water and check the label to see if you need to take them on a full stomach.

Possible side effects include:

  • Increased sensitivity to sunlight
  • Dizziness or lightheadedness
  • Inflamed, torn tendons
  • Low blood sugar in diabetics
  • Irregular heartbeat (if you have low potassium levels)
  • Allergic reactions, such as rash, itchy skin, difficulty breathing—Seek appropriate care if any of these occurs. For breathing difficulties, seek emergency care.

Macrolides and Azalides

Common names include:

Always take these medicines with a full glass of water. While it’s preferable to take erythromycin on an empty stomach, a lot of people experience stomach upset. If you do, try taking it with food. Take azithromycin one hour before or two hours after meals. Some of these drugs can interact with medical conditions and medications. Ask your doctor or pharmacist about any interactions.

Possible side effects include:

  • Rarely, erythromycin can cause jaundice (a yellow cast to the whites of the eyes and the skin).
  • Stomach cramps
  • Nausea, vomiting
  • Diarrhea
  • Rarely, heart beat irregularities (especially when combined with other medications)

Nasal Corticosteroids

Common names include:

Nasal corticosteroids are inhaled directly into your nose through a special inhaler. These drugs may help relieve congestion by decreasing swelling in the lining of the nose. It will likely take a few days of using nasal corticosteroids before you notice an effect; they must be used daily to sustain this effect. These drugs are often used with antibiotics.

Possible side effects include:

  • Dryness of irritation of your nose, including nosebleeds
  • Stuffy nose
  • Sneezing
  • Changes in the sense of smell or taste

If any of the following occurs while you are taking a nasal corticosteroid, call your doctor:

  • Severe coughing, wheezing, or trouble breathing
  • Painful sores or white or red patches inside your mouth or nose
  • Swelling of the tongue or throat
  • Trouble swallowing
  • Continuous stinging or burning feeling in your nose


Common names include:

Be sure to take tetracycline with food to avoid stomach upset. Wait two hours between taking antacids or milk and taking a dose of tetracycline. Doxycycline and minocycline can be taken without regard to food or milk. Always take these medicines with a full glass of water.

Possible side effects include:

  • Stomach cramps, burning
  • Diarrhea
  • Nausea, vomiting
  • Tooth discoloration in children (including those whose mothers took tetracycline while pregnant)
  • Increased sun sensitivity
  • Dizziness or lightheadedness
  • Decreased effectiveness of oral contraceptives—Use another form of contraception while you are taking tetracycline.

Trimethoprim-Sulfamethoxazole (Folate Inhibitors)

Common brand names include:

These medicines are usually not prescribed for babies less than three months of age. The elderly have an increased risk of skin and bleeding problems with these medicines, especially if they are already taking diuretic medicines. Patients with either kidney or liver disease should use these medications with great care.

Always take these medicines with a full glass of water.

Possible side effects include:

  • Bleeding problems, including increased bleeding, easy bruising, slow healing—Delay dental procedures if possible.
  • Increased sun sensitivity
  • Itching
  • Skin rash
  • Nausea, vomiting
  • Diarrhea
  • Stomach cramps
  • Dizziness or lightheadedness

Over-the-Counter Medications


Common brand names include:

Acetaminophen can be helpful in relieving some of the pain and discomfort associated with sinusitis. It’s also safe to give to children. Do not take a larger dose than is recommended by your doctor. Do not drink alcoholic beverages while you are taking acetaminophen.


Common brand names include:

Ibuprofen can also help relieve some of the pain associated with sinusitis. Because some people find ibuprofen to be very hard on the stomach, you should take this medicine with food. Drinking alcoholic beverages while you are taking ibuprofen can increase your risk of stomach irritation.

On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately contact your doctor.

Oral Decongestants

Common brand names include:

These drugs help shrink the nasal passageways and may make it easier and more comfortable for you to breathe.

If you are taking any other medications, check with your doctor before beginning to use these medications. Avoid using caffeinated products while you’re taking these drugs. Don’t drink alcohol, take sedative medications, or use monoamine oxidase inhibitors (MAOI) antidepressants while you are taking oral decongestants.

Before you take oral decongestants, check with your doctor if you have other medical conditions, particularly:

Possible side effects include:

  • Racing heart
  • Feelings of agitation, anxiety
  • Sleepiness
  • Increased blood pressure

Nasal Decongestant Sprays

Common brand names include:

  • Afrin
  • Dristan
  • Sinex
  • Neo-synephrine

These drugs are sprayed directly into the nasal passageways to help shrink the membranes and improve breathing. These products should only be used for less than three days. Longer use can result in increased swelling and congestion, as well as dependency.

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.