Antibiotic therapy for a sinus infection

introduction

Sinusitis, also called sinusitis, is an acute or chronic inflammation of the lining of the sinuses.

Such inflammation can be viral or bacterial, and is often caused by one Rhinitis (Runny nose) or Pharyngitis (Sore throat).

There are four sinuses that can be affected, namely the ethmoid cells, the frontal sinuses, the maxillary sinuses or the sphenoid sinus.
The most common are the maxillary sinus and ethmoid cells (see also: Inflammation of the ethmoid cells) affected by sinusitis.

The inflammation is classified according to location, course and origin, and differentiates between them.
If all sinuses are affected at the same time, one speaks of one Pansinusitis.

The following article takes a closer look at antibiotic therapy for sinus infections.

Is Sinus Infection Contagious? Find out more at How contagious is a sinus infection

Antibiotic therapy

A Antibiosis is a drug treatment with antibiotics that aims to destroy microorganisms such as bacteria and fungi.

However, bacteria are primarily the target of antibiosis.
Antibiotics are powerless against viruses, which is why not all sinusitis can be treated with antibiotics.

Antibiotics also differ in their spectrum of action, so that not every antibiotic is effective against every bacterium.
The opposite is actually the case: many bacteria are resistant to certain classes of antibiotics.

Antibiotic therapy of sinusitis is only effective and sensible if bacteria are the cause of the inflammation and, at best, it is known which bacterium it is.
Only in this way can targeted therapy be carried out.

However, bacterial infections are the cause in only 25-30% of acute sinus infections. Most of the time, the inflammation is viral.
However, there are indications that suggest a bacterial infection:

On the one hand, this is a disease duration of over 7 days,
a unilateral purulent nasal discharge
as well as one-sided facial pain, which manifests itself in the typical feeling of pressure that one experiences with sinusitis.

Bilateral complaints tend to suggest a viral cause.

If there is a confirmed bacterial cause or a strong suspicion, antibiotic therapy can be initiated.
In the case of chronic sinus infections, antibiotics are also prescribed in long-term therapy in addition to other therapeutic approaches.

The type of antibiotic depends on the bacterial pathogen present. Most of them are Staphylococci, Streptococci, Haemophilus influenzae and Pneumococcithat cause the sinusitis.

Overview of potentially effective antibiotics

Below is an overview of potentially effective Antibiotics:

Antibiotics that against Staphylococci effective are:
Are staphylococci gram positive bacteria, which besides many other clinical pictures as well Sinus infections cause.
In particular is the germ Staphylococcus aureus involved in 30% of all people in the nostril, the Nasal cavity and the Throat entrance is located.
With very difficult courses (this is generally true) the bacterial infection can also on neighboring bone structures overlap and so, for example, damage to the eyes or that brain cause.
Staph. Aureus can do the same Meningitis (Meningitis) trigger.
Staphylococci are generally inherent in nature against penicillin resistantso this ineffective is.
Therefore, one primarily deals with Cephalosporins the 1st and 2nd, but also the 3rd generation.
Otherwise, penicillin can also be used in Combination with a Penicillinase inhibitors how Clavulanic acid are given. This penicillinase inhibitor inhibits the enzyme in bacteriawhich would otherwise destroy the penicillin.
Meanwhile are about 20% of the staphylococci strains are also able to develop other resistances, so that methicillin- and oxacillin-resistant Staph. Aureus and staph. epidermidis trunks speaks.
They are popular as the multi-resistant germs MRSA and MRSE known. Here you give Glycopeptides how Vancomycin.
Treatment can up to 4 weeks depending on the severity of the infection and the course of the disease.

Antibiotics that against Streptococci effective are:
Streptococci are also gram-positive bacteria whose incubation period (Time between infection and first appearance of symptoms) about 2 to 4 days lies.
Unlike staphylococci, they are almost always sensitive to penicillinso here is a Treatment with penicillin makes sense.
Mostly will over 10 days treated with the drug.
If the disease progresses very seriously with a sepsis (Blood poisoning), Meningitis or an existing one Endocarditis the therapy is administered parenterally in high doses.
If you are allergic to penicillin, you can Macrolide antibiotics how Erythromycin and Clarithromycin administered.

Antibiotics that against Pneumococci are effective: These pathogens are similar to Streptococci and cause both exogenous (coming from outside the body) as well as endogenous (from inside the body) infections.
So you can by droplet infection be transferred or else starting from the pharynxwhere they are can cause infection.
Most often then they cause Sinus infections, Otitis (Inflammation of the ear), Canaliculitis (Inflammation of the tear duct) and Conjunctivitis (Conjunctivitis).
They solve too Pneumonia (lung infection) out.
There are several different subspecies of the germ, some of which can be used against vaccinate.
If you are ill, there are some antibiotics that are suitable for treatment.
Usually one prescribes Cephalosporins the 3rd generation. These are also well effective with the dreaded complication of a Hood meningitis.
Otherwise are too Penicillins and Gycopeptides how Vancomycin a way of therapy.

Antibiotics that against Haemophilus influenzae effective are:
This bacterium is a gram-negative rod, which is small also in the pharynx is located.
It causes diseases similar to that Pneumococci, however, is less common than this the cause.
Typically it causes Haemophilus influenzae alongside Sinus infections also Otitis (Inflammation of the ear), Canaliculitis (Inflammation of the tear duct) and Conjunctivitis (Conjunctivitis), purulent Bronchitis (Inflammation of the Bronchi) and Epiglottitis (Epiglottis).
Meningitis, sepsis and pneumonia can also occur.
This germ can rarely Resistance to penicillin form.
One therefore gives preference Augmentan, a macrolide antibiotic, or Cephalosporins the 2nd and 3rd generation.
Augmentan is a Combination preparationwhich the antibiotic Amoxicilin and the Penicilinase inhibitors Contains clavulanic acid.

What to do if the antibiotic doesn't help

In acute sinusitis, an antibiotic, provided it works well, should shorten the duration of the illness by an average of 2 to 3 days. Symptoms should improve after 1 to 2 days on antibiotics. If this is not the case, you should see your doctor and discuss how to proceed. However, it is important not to simply stop taking the antibiotic unless you suffer from an intolerance or severe side effects. Discontinuing the antibiotic should be considered carefully, as incomplete intake of antibiotics can lead to bacterial resistance. This makes them more difficult to treat.

Antibiotic therapy in pregnancy

Antibiotics can also be used during pregnancy to fight bacterial, acute sinus infections. However, the treatment should be carefully considered just as it is outside of pregnancy. However, if the criteria for therapy with an antibiotic are present, this should also be taken. The complications of a bacterial sinus infection can otherwise be dangerous for the unborn child. Penicillins such as amoxicillin, which is also the drug of choice, are well tolerated during pregnancy and have no negative effects on the unborn child. Get detailed advice from an ENT specialist.

How long must the antibiotic be taken?

For acute sinus infection, antibiotics are usually prescribed for 5 to 10 days when it makes sense to take them. It is important to take the antibiotic completely for the specified period. An exception is, of course, an intolerance, allergic reaction or severe side effects.

How long does it take to get better?

Improvement occurs when the antibiotic is effective against the bacteria. The prerequisite for this is that the sinus infection is bacterial. A good pre-selection of patients who are likely to have a bacterial infection based on their symptoms will improve the effectiveness of the therapy. Then after about 1 to 2 days with antibiotic therapy an improvement should occur. However, it can also take 3 to 4 days, this varies greatly from person to person.

How high is the risk of infection with a sinus infection when taking antibiotics?

As a rule, the risk of infection decreases from about the third day of taking the antibiotic. However, it is difficult to give an exact time. The antibiotic must still be taken to the end, as only then can the killing of all bacteria be guaranteed.

Can you do sports if you have a sinus infection and are taking antibiotics?

Sports activities should be avoided during an acute infection. Sport is in principle very beneficial for your health, but you should take it easy in a phase of illness. You should also not be fooled by symptoms that have subsided when taking antibiotics: the disease is not over at this point. Physical exertion during an infection can lead to the disease spreading. In addition, pathogens can be carried into the heart and the heart valves. Heart muscle inflammation is particularly feared, which can occur in particular when you exercise while you have a fever. As a rule of thumb, do not exercise for up to 3 days after recovering from the illness and taking all antibiotics. After that, start with a light intensity and gradually increase. If you are unsure when to start training again and what intensity is appropriate, do not be afraid to consult your doctor. He can professionally assess your state of health and provide you with advice.

Summary

Antibiotic therapy is indicated when the cause of the sinus infection is bacterial.

The antibiotic chosen depends on the pathogen that has been confirmed or is suspected to be the cause.

The pathogens that cause sinusitis are Staphylococci, Streptococci, Pneumococci or Haemophilus influenzae.
They differ in their sensitivity to antibiotics, so that different active ingredients are used in therapy.

Staphylococci is mainly treated with 1st and 2nd generation cephalosporins. They are resistant to penicillin.
Glycopeptides such as vancomycin are used in MRSA and MRSE.

Streptococci are sensitive to penicillin so it can be used for treatment. If you are intolerant, you can switch to macrolides such as erythromycin and clarithromycin.

Should Pneumococci Cephalosporins of the 3rd generation or glycopeptides such as vancomycin are most commonly used.

Against Haemophilus influenzae one usually takes Augmentan or cephalosporins of the 2nd and 3rd generation. Macrolides can also be used.

You can also read a lot more information at: Treatment of a sinus infection