On Sinusitis: Antibiotics are not necessary in the “vast majority” of cases



There’s a terrific article on sinusitis by Consumer Reports that underscores the Golden Rule of antibiotic usage: Never use them for viral-driven infections – which sinusitis almost always is – because (1) they aren’t doing a thing for what’s wrong with you, thus your condition could worsen, and (2) antibiotics are powerful drugs that produce adverse side-effects – they make you feel worse – in a quarter of the people that use them.

The bottom line: “For acute sinusitis, there are very well-done studies (JAMA) indicating that antibiotics are not necessary in the vast majority of patients, and most people will be able to clear an infection on their own,” says ZaraPatel, MD, assistant professor of Otolaryngology at the Stanford University Medical Center.

The chief concern with them is they can make you sickerFor instance, antibiotic use increases the chances of developing an infection caused by clostridium difficile bacteria that can result in life-threatening diarrhea. Almost half a million Americans contracted the infection in 2011, resulting in 15,000 deaths. Other side effects include stomach problems, dizziness/nausea, rashes, vaginal infections, swelling of the face and throat, and breathing problems. Some antibiotics can even cause permanent nerve damage and torn tendons.

Even if bacteria are the cause, the infections usually clear up on their own in about a week. In the meantime, to loosen mucus and help it drain, drink warm liquids – a salt water gargle helps some people; use a hot shower, bath, or a kettle, to breathe warm, moist air; keep your head propped up when you lie down; and because you’re fighting a virus, it’s important to rest.

But never say never. You would consider an antibiotic if: you get better and then worse again; don’t get better after 10 days; you have a fever of 102 or more; you have severe face pain and tenderness; or you have thick, colored mucus for three or more days in a row.

In any event, the purpose of this and the Consumer Reports article is to help you have a better conversation with your physician. The following video will also help and it provides a nice summary of the issues surrounding sinusitis:


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