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Suggest Treatment For Post-nasal Drip While On Levofloxacin And Fluconazole
Question: I had sinus surgery over 8 weeks ago to remove fungus. Then I started having nostril drip with kind of light green or yellow. My doctor prescript me Levofloxacin 500 mg for a week worth. It did not clear up. Then he took culture test and gave me 10 days of Fluconazole. It still did not clear. I still smell bad. Then he gave me another 10 days of Fluconazole. I still have nostril drip with yellow/green when I bend over my head. I do not know what to do now. I have been using seline to clean my nostril two-three times a day. I am not sure if it is infection or fungus.
Brief Answer:
Most likely bacterial sinusitis;another culture testing advised to run
Detailed Answer:
Hi XXXXXXX shideler,
I have gone through your medical history carefully and understood your concerns.
You are saying to:
- have had a sinus surgery over 8 weeks ago to remove fungus
- then, started to have nostril drip with light green/yellow discharge which still continues
- have used a course of Levofloxacin and 2 courses of Fluconazole
and you are still having yellow/green discharge coming from your nostrils. It is indicating bacterial infection. I advise to take another nasal swab culture but this time do not use any medication (antifungal or antibacterial) for at least 3 days prior to testing. This is to ensure you won't have false negative results.
Antibiotics then are advised to use according to the susceptibility results. If levofloxacin is not working, then, other antibiotics of other groups are recommended if you are not allergic to them (e.g. penicillins, trimethoprim-sulphametoxazole; doxycycline, etc.)
Fluconazole won't help in a bacterial infection. If the culture is determining it is fungal infection, then, another anti-fungal agent should be used (e.g. ketoconazole, or itraconazole).
Once again, another culture testing is advised to run as mentioned above to determine/rule out bacterial infection.
Hope it was of help!
Dr.Albana
Most likely bacterial sinusitis;another culture testing advised to run
Detailed Answer:
Hi XXXXXXX shideler,
I have gone through your medical history carefully and understood your concerns.
You are saying to:
- have had a sinus surgery over 8 weeks ago to remove fungus
- then, started to have nostril drip with light green/yellow discharge which still continues
- have used a course of Levofloxacin and 2 courses of Fluconazole
and you are still having yellow/green discharge coming from your nostrils. It is indicating bacterial infection. I advise to take another nasal swab culture but this time do not use any medication (antifungal or antibacterial) for at least 3 days prior to testing. This is to ensure you won't have false negative results.
Antibiotics then are advised to use according to the susceptibility results. If levofloxacin is not working, then, other antibiotics of other groups are recommended if you are not allergic to them (e.g. penicillins, trimethoprim-sulphametoxazole; doxycycline, etc.)
Fluconazole won't help in a bacterial infection. If the culture is determining it is fungal infection, then, another anti-fungal agent should be used (e.g. ketoconazole, or itraconazole).
Once again, another culture testing is advised to run as mentioned above to determine/rule out bacterial infection.
Hope it was of help!
Dr.Albana
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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