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The controversy behind curing chronic sinusitis with antibiotics

A clinical practice review of Acute Sinus Infections published in the New England Journal of Medicine in adults was asked to review. The reason being the study stated that the majority of sinusitis improves or clears on their own without the use of any antibiotics. Moreover, the infections cure within one to two weeks. While the reality is completely different. 

In reality, whenever we have a dripping nose with pain around the nose, several doctors are always in a hurry to prescribe antibiotics without realizing the after-effects. Popping these pills without giving a second thought not only causes side effects but also makes the patient bacterial resistant. Hence, when the study was asked to review clinical researchers and public health people were on their toes. 

After this discrepancy, several guidelines including practice guidelines were established jointly by the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology, the Joint Council of Allergy, Asthma and Immunology to make sure that antibiotics are used judiciously.

Do You Know?: Link Between Sinusitis and Asthma

How well do antibiotics work for sinusitis?

Patients who have terrible pain due to sinusitis, be it acute or chronic, visit the E.N.T doctor for the prescription of pain relievers. But what we fail to understand is that popping antibiotics whenever you have symptoms of sinusitis may not be the right choice. The immunity system is designed in a way to cure mild or moderate sinusitis or else the body becomes antibiotic-resistant. 

Don’t believe me? There’s scientific evidence to prove the above statement. According to a study of symptom relief published in the Journal of the American Medical Association, there was no difference in effect between patients who took antibiotics and those who didn’t. In this study, 240 patients of sinusitis were observed. These patients were given four types of treatments- 

  • Using only antibiotics
  • Using only nasal steroid sprays to reduce swelling of tissues
  • Both antibiotics and the spray
  • No treatment

antibiotics and nasal sprays

The findings revealed that the patients who received no treatment were more prone to get better than those who got antibiotics. In addition to this, people who received nasal spray treatment were benefited at the beginning of their sinus problem and worsened the condition in those having chronic congestion.

Comparison between taking antibiotics and not taking antibiotics.

Taking antibiotics Not taking antibiotics
Benefits You will start to feel better in 3 to 4 days. These are most effective for curing bacterial infections.
  • Can getter better between 10 to 14 days.
  • Limit the risk of becoming antibiotic-resistant. 
Risks and side effectsSide effects include bad taste in the mouth, upset stomach, dizziness, rashes diarrhea, and vaginal yeast infection.

Taking these medicines more often can make you resistant towards it.  

  • The sinus infection gets worse
  • The infection doesn’t cure on its own.

How to treat Sinusitis at home without antibiotics?

From the comparison above, it can be inferred that irrespective of the type of infection, people can better without taking antibiotics. Here is a list of home treatment for sinusitis that can help with the symptoms of sinusitis-

home remedies for chronic sinusitis

  • Drink lots of fluid to thin out the mucus
  • Apply a hot, damp towel or gel pack to the face for 5 to 10 minutes three times a day for moist heat.
  • Inhale steam from a hot shower, hot bath, or a sink filled with hot water
  • To keep the nasal passages open and to wash out mucus and bacteria, use salt water nasal washes.
  • Get saline drops or sprays to make your own saline solution at home. Make sure that you use distilled water or water that has been boiled and then cooled down.
  • Gargle with warm saltwater.
  • Take over-the-counter medicines such as pain relievers and decongestants to feel better after proper consultation. 
  • Blow your nose gently as blowing too hard can force thick mucus back into the sinuses.

Also Read: Foods to avoid in Sinusitis  

Who should use Antibiotics?

People whose immunity is not built enough to fight off these infections, such as diabetes or cardiovascular patients, should use antibiotics. If the symptoms last longer than 7 days, improves but then worsens again, or extremely severe, then consider using antibiotics. Look out for the following symptoms for immediate antibiotic treatment-

  • Fever over 38.6 degrees C
  • Extreme pain and tenderness over the sinuses
  • Hot, red rash that spreads quickly

The doctors recommend CT scans when there are frequent or chronic sinus infections or undergoing sinus surgery. 

Best treatment for Sinusitis

The most-effective treatment for curing sinusitis caused by a physical deformity such as a deviated septum is a FESS surgery. This is so because, despite the guidelines, there is still overuse of antibiotics for sinusitis. This is a minimally invasive technique in which the E.N.T doctor clears the sinuses using an endoscope so that the patients can breathe freely. This day-care procedure involves minimum cuts or incisions which offer several benefits-

  • Almost no pain
  • Minimum bleeding
  • Faster recovery
  • No visible scarring
  • Long-lasting results 

Also Read: Correlation between a deviated septum and chronic sinusitis!

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