Stephen J. Schueler, M.D.

Acute Sinusitis Treatment

Most cases of sinusitis don't require treatment because they are caused by a virus and go way by themselves. General measures for sinusitis include saline nasal spray, antihistamine medications, decongestant medications, and nonsteroidal anti-inflammatory medications for pain or fever control. Antibiotics may be prescribed for sinusitis due to a bacterial infection. Rarely, surgery is required to treat chronic sinusitis.

Specific treatment for sinusitis may include:

Acute Sinusitis Drugs

There are a variety of drugs that are useful in the treatment of sinusitis.

Nasal decongestants
Oral nasal decongestants may relieve sinus congestion making breathing easier. Decongestant nasal sprays are also very effective. These sprays should not be used for longer than 3-4 days. Prolonged use can worsen congestion.

Commonly recommended oral decongestants and nasal sprays include:

Antihistamines, such as diphenhydramine, may provide relief of nasal congestion in those with allergic sinusitis. Avoid antihistamines if you have allergic sinusitis, because the medication can thicken the mucus.

Commonly recommended oral antihistamines include:

Anti-inflammatory medicines
Chronic allergic sinusitis may respond to nasal corticosteroid spray, such as Flonase or Nasacort. These medications reduce inflammation caused by exposure to allergens. Cromolyn is another medication that reduces inflammation.

Anti-inflammatories used to treat sinusitis include:

Research has shown that viruses cause most cases of acute sinusitis. All cases of viral sinusitis and many cases of mild bacterial sinusitis do not improve with antibiotics. However, antibiotics may be necessary in acute sinusitis. Those with a fever, a thick or bloody nasal discharge and persistent facial pain may improve with an antibiotic. Culture of the sinus discharge may help to guide antibiotic selection. Antibiotic therapy may be necessary for 4 or more weeks in people with chronic bacterial sinusitis.

Commonly prescribed antibiotics for acute sinusitis include:

Acute Sinusitis Questions For Doctor

The following are some important questions to ask before and after the treatment of sinusitis.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Am I contagious?
    • For how long?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • What else can I do to reduce my risk for having sinusitis again?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Acute Sinusitis Specialist

Physicians from the following specialties evaluate and treat sinusitis:

Acute Sinusitis Surgery

Surgery may be required to treat those who have chronic sinusitis that does not improve after treatment with antibiotics.

Surgery may also be required to treat sinusitis in those who have:

Continue to Acute Sinusitis Home Care

Last Updated: Jun 14, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Acute Sinusitis References
  1. Brook I. Microbiology and antimicrobial management of sinusitis. J Laryngol Otol. 2005 Apr;119(4):251-8. [15949076]
  2. Klossek JM, Federspil P. Update on treatment guidelines for acute bacterial sinusitis. Int J Clin Pract. 2005 Feb;59(2):230-8. [15854202]
  3. Mortimore S, Wormald PJ. Management of acute complicated sinusitis: a 5-year review. Otolaryngol Head Neck Surg. 1999 Nov;121(5):639-42. [10547486]
  4. Oxford LE, McClay J. Complications of acute sinusitis in children. Otolaryngol Head Neck Surg. 2005 Jul;133(1):32-7. [1602504]
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