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Antibiotics Don't Help Most Sinus Infections

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Sinus infections are not pleasant. They often present with a runny nose, cough, pain around the face, fever and generalized fatigue. While some individuals may never develop a sinus infection, there are other unlucky people who tend to develop recurrent episodes of sinusitis.

Sinusitis often makes it difficult to work, breath and sleep. It can even confine one to the home.

Most individuals quickly go to their physician for treatment of the nasal drip and congested nasal passages. For the most part, doctors readily prescribe a variety of antibiotics for sinus infections.

It is estimated that nearly 20 percent of all antibiotics prescribed today are for sinus or ear infections. (3) This represents millions of doses of antibiotics with a cost running into billions of dollars for the consumer.

Now that may all be changing. A new study questions the wisdom of routinely prescribing antibiotic for sinus infections. The latest study suggests that instead of immediately prescribing antibiotics, the doctors should monitor the patient to determine if they develop worsening of the symptoms.

In this study conducted by Dr Jane Garbutt from Washington University School of Medicine, St. Louis, patients treated with antibiotic for their sinus infections only had a small improvement compared to people who were treated with a placebo (sugar pill).

So what is the explanation for these confounding results?

Dr. Garbutt indicated that in most cases, sinus infections are due to viruses and not bacteria. Since viruses do not respond to antibiotics, there will be no difference in outcome even when one is prescribed these drugs.

It is only the rare patient who may have a bacterial sinus infection but unfortunately the doctor cannot tell by just looking whether it is a viral or bacterial infection. (1)

Based on these observations, doctors are advised to follow the patients and only prescribe antibiotics to patients whose symptoms are getting worse.

In the last three decades there has been great concern that antibiotics are liberally prescribed by physicians. While these medications are useful, prolonged and unnecessary usage has led to development of drug resistance and of course, there is also a potential for side effects.

One of the biggest problems with overuse of antibiotics has been the emergence of methicilin-resistant staphylococcus aureus.

How this study will change doctor's practice in the treatment of sinus infections remains to be seen. Many physicians still continue to prescribe antibiotics for ear infections and bronchitis despite clinical evidence showing that these disorders are due to viruses and not bacteria. (2)

For the consumer, this does not mean that sinusitis does not have to be treated at all. The infection often presents with a variety of annoying symptoms which can easily be treated with home remedies.

The odd ache and facial pain can be treated with over-the-counter pain medications like Motrin. Moreover, these medications will also help reduce the fever.

It is difficult to prevent sinus infections when living in a cool temperate climate but immediately rushing to a physician at the first sign of symptoms is not recommended. Since most sinus infections are viral, try home remedies first.

Only if the symptoms persist for more than seven days, a visit to the doctor may be worthwhile. This will not only save you money but also the agony of waiting for hours before you get seen by the doctor.


1. Garbutt JM, Amoxicillin for acute rhinosinusitis: a randomized controlled trial.

2. Spurling GK, Delayed antibiotics for symptoms and complications of respiratory infections.

3. Too Many Antibiotics Prescribed For Sinus Infections. Medical News Today. Retrieved Feb. 21, 2012

Reviewed February 22, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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EmpowHER Guest

The theory you are proposing "that most sinus infections are caused by viruses and not bacteria" in my experience is not true. I regularly catch sinus infections which used to spread throughout my whole body, causing a cold which could last up to two weeks. Nowadays, I use an antibacterial nasal spray (Vicks First Defense) at first sign of infection, and the symptoms go away within 24 hours.

August 1, 2012 - 5:40am
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