An antibiotic is a soluble substance derived from a mold or bacterium
that inhibits the growth of other microorganisms.
The first antibiotic was Penicillin, discovered by Alexander Fleming in
1929, but it was not until World War II that the effectiveness of
antibiotics was acknowledged, and large-scale fermentation processes were
developed for their production.
Acute sinusitis is one of many medical disorders that can be caused by a
bacterial infection. However, it is important to remember that colds,
allergies, and environmental irritants, which are more common than bacterial
sinusitis, can also cause sinus problems. Antibiotics are effective only
against sinus problems caused by a bacterial infection.
The following symptoms may indicate the presence of a bacterial infection
in your sinuses:
- Pain in your cheeks or upper back teeth
- A lot of bright yellow or green drainage from your nose for more
than 10 days
- No relief from decongestants, and/or
- Symptoms that get worse instead of better after your cold is gone.
Most patients with a clinical diagnosis of acute sinusitis caused by a
bacterial infection improve without antibiotic treatment. The specialist
will initially offer appropriate doses of analgesics (pain-relievers),
antipyretics (fever reducers), and decongestants. However if symptoms
persist, a treatment consisting of antibiotics may be recommended.
Antibiotic Treatment For Sinusitis
Antibiotics are labeled as narrow-spectrum drugs when they work against
only a few types of bacteria. On the other hand, broad-spectrum antibiotics
are more effective by attacking a wide range of bacteria, but are more
likely to promote antibiotic resistance. For that reason, your ear, nose,
and throat specialist will most likely prescribe narrow-spectrum
antibiotics, which often cost less. He/she may recommend broad-spectrum
antibiotics for infections that do not respond to treatment with
narrow-spectrum drugs.
Acute Sinusitis
In most cases, antibiotics are prescribed for patients with specific
findings of persistent purulent nasal discharge and facial pain or
tenderness who are not improving after seven days or those with severe
symptoms of rhinosinusitis, regardless of duration. On the basis of clinical
trials, amoxicillin, doxycycline, or trimethoprim–sulfamethoxazole are
preferred antibiotics.
Chronic Sinusitis
Even with a long regimen of antibiotics, chronic sinusitis symptoms can
be difficult to treat. In general, however, treating chronic sinusitis, such
as with antibiotics and decongestants, is similar to treating acute
sinusitis. When antibiotic treatment fails, allergy testing,
desensitization, and/or surgery may be recommended as the most effective
means for treating chronic sinusitis. Research studies suggest that the vast
majority of people who undergo surgery have fewer symptoms and better
quality of life.
Pediatric Sinusitis
Antibiotics that are unlikely to be effective in children who do not
improve with amoxicillin include trimethoprim-sulfamethoxazole (Bactrim) and
erythromycin-sulfisoxazole (Pediazole), because many bacteria are resistant
to these older antibiotics. For children who do not respond to two courses
of traditional antibiotics, the dose and length of antibiotic treatment is
often expanded, or treatment with intravenous cefotaxime or ceftriaxone
and/or a referral to an ENT specialist is recommended.