When we feel miserable with a sinus infection, we just want a magic pill to make the symptoms go away. Some people expect to go to their doctor and get an antibiotic for treatment. This can be a bad idea if it’s not the cause of the infection. We live in a time where antibiotic resistance is a big problem. Handing out antibiotics for treating colds that are due to viruses, is the main reason for this resistance problem. So here are some things to know…
The correct term is actually, “rhinosinusitis.” This is when the mucous lining in the paranasal sinuses and nasal cavity become inflammed. It effects 1 in 7 adults each year in the U.S. It causes swelling and blockage of the normal openings that drain mucous. It also decreases the function of cilia (small hair-like structures) which are responsible for sweeping out mucous and debri from the nasal cavity.
Most (>80%) infections are due to viruses, which originate from the common “cold”. We catch these colds from direct contact by touching a surface with the virus on it and then touching our face, wiping our nose or mouth. The other way it is spread is through airborne droplets that occur when someone coughs.
In the first 3-4 days of illness, you can’t tell a viral or bacterial infection apart. Symptoms are similar which includes nasal congestion, runny nose, loss of smell or taste, post nasal drip, sore throat, tooth and facial pain/pressure, fatigue, headache, bad breath and fever. Thick green mucous does not mean it is a bacterial infection needing antibiotics. This can be viral or it can indicate that the infection is coming to the end of its cycle and almost cleared.
During the first 7-10 days, it is best to do nasal washes with saline which you can make on your own, using 1 cup of warm filtered water and adding 1/4 tsp of sea salt and 1/8 tsp of baking soda. You can also use this solution for gargling if you have a sore throat. Decongestants are also helpful with nasal swelling and post nasal drip. You can try a homeopathic remedy or use over-the-counter Sudafed. Drink lots of water, get rest and fresh air. Exercise is fine as long as you are not running a fever. Try to avoid sugar, alcohol and coffee which can compromise the immune system.
So when to think about antibiotics? If your symptoms worsen over 10 days or you improve after the first few days and then your symptoms come back much worse. Also, predominant sinus pain on one side and discharge that looks like pus are times when you should see your practitioner.
Always wash your hands and cover your mouth with your arm or a tissue, (rather than your hands) when sneezing or coughing. Try to stay away from sick people if you can. There are some people that need to be referred to a specialist if symptoms continue to worsen after maximum treatment.
Aring, A et al. Current Concepts in Adult Acute Rhinosinusitis. American Family Physician. July 15, 2016 Vol. 94. Number 2