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Suggest Treatment For Severe Sinus Infection
Question: I have a sinus infection. This is week 5, and its shows no sign of getting better. Two ad a half weeks ago I saw a Physician's Assistant at my usual health clinic. I was told that a sinus infection is most likely a virus, so wouldn't respond to antibiotics. I used to have this problem almost every winter, and after waiting 10 days or 2 weeks with no improvement, I would be prescribed Azithromycin, and would be noticeably better in a couple of days, and would finish the medication as prescribed, and feel like my self again.
I had a blood workup done, which showed some unidentified in infection at the time of that appoitment; I'm going for another blood test done tomorrow for comparison. I know nothing has changed.
I just talked to a city employee while paying my utility XXXXXXX by phone. She told me that three of the staff in her office had been out with sinus infection/flu. They were given antibiotics, two are back to work, and the third is expected tomorrow. Do you have any suggestions? I am pretty much limited to my managed care Medicare program, which has served me well until now. Do you have any suggestions?
P.S., I've been told by doctors over the last 10 years that I have a weak immune system, which I know is true, because I am pretty much never able to fight off infections on my own.
I had a blood workup done, which showed some unidentified in infection at the time of that appoitment; I'm going for another blood test done tomorrow for comparison. I know nothing has changed.
I just talked to a city employee while paying my utility XXXXXXX by phone. She told me that three of the staff in her office had been out with sinus infection/flu. They were given antibiotics, two are back to work, and the third is expected tomorrow. Do you have any suggestions? I am pretty much limited to my managed care Medicare program, which has served me well until now. Do you have any suggestions?
P.S., I've been told by doctors over the last 10 years that I have a weak immune system, which I know is true, because I am pretty much never able to fight off infections on my own.
Brief Answer:
Information
Detailed Answer:
Hello XXXXXXX
The Physician's Assistant is incorrect - which is why it is good to see a doctor.
The reason we are advised to no longer give antibiotics for sinus infections in the first 3 weeks is not that they are caused by a virus but rather that they usually resolve within 3 weeks and in this age of antibiotic resistance, antibiotics such as Azithromycin should be reserved for more severe infections like pneumonia.
However, if after 3 weeks a patient has not recovered from their infection, an antibiotic is indicated.
While flu (influenza) can go around in a community, sinus infections do not - they are more a function of what our bodies do with colds and flu. Colds and flu are caused by viruses. But if you are prone to sinus infections, colds and flu and increase the chance that you develop a secondary infection in your sinuses. Once established, this is a bacterial infection.
At this point go in to see a doctor and you will get an antibiotic. I also recommend, if you are prone to sinus infections, to use a steroid nasal spray to decrease the inflammation and swelling of your sinus mucus membranes. In addition, saline rinses can help too, but don't do these at the same time as the steroid nasal spray or it will just wash it out (if used after) or cause the steroid medicine to drip down into your stomach (if used before).
I hope this information helps.
Information
Detailed Answer:
Hello XXXXXXX
The Physician's Assistant is incorrect - which is why it is good to see a doctor.
The reason we are advised to no longer give antibiotics for sinus infections in the first 3 weeks is not that they are caused by a virus but rather that they usually resolve within 3 weeks and in this age of antibiotic resistance, antibiotics such as Azithromycin should be reserved for more severe infections like pneumonia.
However, if after 3 weeks a patient has not recovered from their infection, an antibiotic is indicated.
While flu (influenza) can go around in a community, sinus infections do not - they are more a function of what our bodies do with colds and flu. Colds and flu are caused by viruses. But if you are prone to sinus infections, colds and flu and increase the chance that you develop a secondary infection in your sinuses. Once established, this is a bacterial infection.
At this point go in to see a doctor and you will get an antibiotic. I also recommend, if you are prone to sinus infections, to use a steroid nasal spray to decrease the inflammation and swelling of your sinus mucus membranes. In addition, saline rinses can help too, but don't do these at the same time as the steroid nasal spray or it will just wash it out (if used after) or cause the steroid medicine to drip down into your stomach (if used before).
I hope this information helps.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your reply and the explanation of the progression from virus to bacterial infection. I scheduled a phone visit with my long-time family physician; she prescribed azithromycin, which I finished yesterday. I feel almost well again, I think it will be a while before I work up to having any energy after 6 plus weeks of being sick.
Since I have been prone to sinus infections for years, I'd like to follow up on your suggestion to use a steroid nasal spray. Will I need a prescription? Can you tell me what to ask for? Also, last May, I tripped over a broken side walk curb, and landed on the left side of m face. Now I'm told I have a deviated septum. Should I pursue having it corrected, if possible? I don't really know where to start. Many thanks, Susan Cicotte
Since I have been prone to sinus infections for years, I'd like to follow up on your suggestion to use a steroid nasal spray. Will I need a prescription? Can you tell me what to ask for? Also, last May, I tripped over a broken side walk curb, and landed on the left side of m face. Now I'm told I have a deviated septum. Should I pursue having it corrected, if possible? I don't really know where to start. Many thanks, Susan Cicotte
Brief Answer:
Information
Detailed Answer:
Hello XXXXXXX
I'm glad to hear you are on the mend from pneumonia. Azithromycin is an excellent antibiotic for pneumonia. I wish doctors, PAs, and NPs would refrain from using it for more minor infections as bacterial resistance can develop and then it won't be useful for the more severe infections.
Corticosteroid nasal sprays are now sold without prescription. You can buy Flonase in any drugstore. Follow the directions that are included in the packaging for how to use it. Used on a daily basis, it can decrease sinus mucus membrane swelling and may help your overall problem. Careful not to spray towards the midline, which is where your nasal septum is. If, due to the deviated septum, it is difficult for you to use the spray on one side, do not force it.
If this doesn't help adequately (you should know in 2-3 weeks), then I recommend a consult with an ENT doctor (ear nose throat/otolaryngologist).Many people have deviated nasal septae and it doesn't necessarily cause problems. If, however, yours is severe and causing you repeated problems over time, then the ENT doctor may recommend surgical correction.
Something that has helped me to decrease the number of upper respiratory infections is something I was taught during my pediatric rotation as a medical student. Our teacher told us not to touch our eyes or nose with our hands unless we had immediately prior to this washed out hands well (with regular soap) and not touched anything in between. Otherwise, a tissue to wipe the eyes or nose is acceptable if your fingers don't first contaminate the section of the tissue being used. In addition, I learned to wash my hands and face after coming home from being in public places or work. This helped me a great deal. If you are prone to sinus infections, reducing your risk of colds can help decrease your risk of them turning into a sinus infection.
Some people benefit from taking supplemental vitamin C and Zinc at the very start of getting a cold. There isn't scientific evidence to back that up, but it seems to help some people on an individual basis.
I hope this information helps!
Information
Detailed Answer:
Hello XXXXXXX
I'm glad to hear you are on the mend from pneumonia. Azithromycin is an excellent antibiotic for pneumonia. I wish doctors, PAs, and NPs would refrain from using it for more minor infections as bacterial resistance can develop and then it won't be useful for the more severe infections.
Corticosteroid nasal sprays are now sold without prescription. You can buy Flonase in any drugstore. Follow the directions that are included in the packaging for how to use it. Used on a daily basis, it can decrease sinus mucus membrane swelling and may help your overall problem. Careful not to spray towards the midline, which is where your nasal septum is. If, due to the deviated septum, it is difficult for you to use the spray on one side, do not force it.
If this doesn't help adequately (you should know in 2-3 weeks), then I recommend a consult with an ENT doctor (ear nose throat/otolaryngologist).Many people have deviated nasal septae and it doesn't necessarily cause problems. If, however, yours is severe and causing you repeated problems over time, then the ENT doctor may recommend surgical correction.
Something that has helped me to decrease the number of upper respiratory infections is something I was taught during my pediatric rotation as a medical student. Our teacher told us not to touch our eyes or nose with our hands unless we had immediately prior to this washed out hands well (with regular soap) and not touched anything in between. Otherwise, a tissue to wipe the eyes or nose is acceptable if your fingers don't first contaminate the section of the tissue being used. In addition, I learned to wash my hands and face after coming home from being in public places or work. This helped me a great deal. If you are prone to sinus infections, reducing your risk of colds can help decrease your risk of them turning into a sinus infection.
Some people benefit from taking supplemental vitamin C and Zinc at the very start of getting a cold. There isn't scientific evidence to back that up, but it seems to help some people on an individual basis.
I hope this information helps!
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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