TREATMENT FOR ACUTE SINUS INFECTIONS

/ August 14, 2013/ Sinus, Sinus Infections, Sinusitis & Rhinitis/ 1 comments

TREATMENT FOR ACUTE SINUS INFECTIONS

Douglas Nadel, MD Board Certified in Otorhinolaryngology Pinnacle ENT Associates www. Pentadocs.com About the author: Dr. Nadel has been practicing Otolaryngology (Ear, Nose, and Throat) in Doylestown, Pennsylvania since 1997. He completed Medical School and Residency training at the University of Pennsylvania.

Usually sinus infections cause pain or pressure around the eyes, in the cheeks, in the upper teeth, or around the bridge of the nose.  There is usually a green, yellow, brown, or even bloody discharge from the nose or down the back of the throat.  A sinus infection can start as a simple Cold or allergy flare, which causes swelling and obstruction of the sinuses.  The mucous trapped in these sinuses allows bacteria to flourish, leading to a full-blown sinus infection.

Antibiotics:   Colds are caused by viruses which are not sensitive to antibiotics, but when there is heavy discolored nasal drainage or if symptoms last more than seven days, you are likely to have a bacterial infection.  Antibiotics kill bacteria and are usually taken for ten days.

Decongestants:    Sudafed (pseudoephedrine) is in many over-the-counter cold remedies.  It can decrease the swelling in your nose and sinuses, allowing the infected mucous to drain out.  It is important for this material to drain out of your sinuses, otherwise the infection will persist.  A common side effect of this medication is sleeplessness or feeling jittery, so you may not want to take decongestants at night.

Decongestant nose sprays:   Afrin (oxymetazoline), Dristan, Neo-synephrine, and generic decongestant sprays are very potent medications that can greatly improve the drainage from your sinuses.   These medications should only be used for 3 days.  After that your nose can become “hooked” on the sprays and will be even more congested than when you started using them.

Mucous thinners:  Guaifenesin is an ingredient found in many cough and cold remedies.  It loosens up the mucous allowing it to drain better.  Guaifenesin is available over-the-counter as Mucinex.

Nasal saline spray:  This is simply a balanced solution of salt water.  Using copious amounts of the spray can help flush out the infected mucous from your nose and will keep the discharge from becoming dried out.  This simple treatment is one of the most important means of helping your infection resolve.  Ocean and Ayr are popular brands, and generic saline works just as well.  Simply Saline is free from preservatives, which some people are sensitive to.

A “Neti pot” or Saline Irrigator can more thoroughly wash out the sinuses and help treat colds, allergies, and sinus infections.  Some people use their Irrigator only when they are sick; others like using it once a day every day to help prevent infections from starting.  See www.neilmed.com for more information.

Antihistamines:   Over-the-counter Benadryl (diphenhydramine), Claritin (loratadine, Alavert), Clarinex (desloratadine), Allegra (fexofenadine), Zyrtec (cetirizine), and others are excellent for blocking allergy reactions but can worsen a sinus infection because they dry out your nose and prevent your sinuses from draining properly.  Remember, you want to flush out all that infected material.  On the other hand, some people have such severe allergies that they still need to take their antihistamines during an infection.  These drugs are available with a decongestant as Claritin-D, Allegra-D, and Zyrtec-D.

Prescription nose sprays:  Nasal Steroid sprays, such as Flonase (fluticasone), Rhinocort, Nasacort (triamcinolone), Nasonex,  Nasarel, Veramyst, Qnasl, Zetonna, and others are an excellent treatment for chronic sinus problems and allergies.  They probably do help, to a small extent, with acute sinus infections, but work best preventively.  Nasal Antihistamine sprays, such as Astelin (azelastine), Astepro, and Patanase can help with allergies, but don’t help with sinus infections per se.  Dymista is a combination of a steroid and an antihistamine.

Steroid pills:  Prednisone or Medrol is occasionally necessary for severe, persistent infections, especially for people with severe allergies or nasal polyps.  Common side effects are mood swings, sleeplessness, and upset stomach.  More serious side effects, such as joint problems, can occur, especially with high doses or prolonged courses of treatment.  Steroid pills can worsen Diabetes, High Blood Pressure, Glaucoma, Ulcers, and Tuberculosis.

Pain medication:   Tylenol (acetaminophen), Advil or Motrin (ibuprofen), or Aleve (naprosyn)  can help relieve the facial pain, pressure, and headache that accompany a sinus infection.  Stronger pain medication is rarely necessary.

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