Medical treatment for acute viral sinusitis typically focuses on reducing sinus and nasal inflammation and keeping the drainage pathways open and properly functioning. Medications are commonly recommended to help decrease the severity and duration of symptoms, and may include:
Decongestant Nasal Sprays. Help to treat swelling but shouldn’t be used for more than 3 days (e.g., Afrin).
Decongestants. Help to relieve sinus pain and pressure but should only be used for a short time (e.g., Allegra-D).
Eye Drops. Treat red, itchy eyes (e.g., Olopatadine).
Nasal Antihistamines. Help treat allergy symptoms (e.g., Azelastine).
Nasal Corticosteroids. Help with nasal congestion (e.g., Flonase).
Nasal Irrigations. Help to flush out your sinuses and help loosen thick mucus.
(Use a neti pot with distilled or sterile water that has been boiled 3 to 5 minutes and cooled. Note: Do not use regular tap water as it is not safe to use because it has not been properly filtered or treated, and could lead to serious infections in your nasal passages.)
Oral Antibiotics. Treat bacterial infections (e.g., Acute Rhinosinusitis), and is prescribed for 10 to 14 days (e.g., Amoxicillin).
Oral Antihistamines. Help treat allergy symptoms (e.g., Benadryl).
Oral Steroids. Treat both acute and chronic sinusitis (e.g., Prednisone).
Over-the-Counter Pain Relievers. Help to relieve pain and aches (e.g., Motrin).
Over-the-Counter Cold Medicines. Help to relieve cold symptoms, but check with your doctor first, as some of these medications may make your symptoms worse (e.g., expectorants like Mucinex – loosens phlegm and bronchial secretions).
Saline Nasal Sprays. Help to clean out your nasal passages and help clear congestion (e.g., Ayr).
Of course, each of these medications has its advantages and disadvantages (side effects), which your ENT doctor will discuss with you. For acute bacterial sinusitis, your ENT doctor may base the choice of antibiotic on many factors, including:
- The most likely type of bacteria causing the infection
- The potential resistance of the bacteria to certain antibiotics
- Any medication allergies that you may have
- Other medications that you are taking
- Other medical conditions that you are being treated for
- Previous treatments that you have undergone
Antibiotic treatment is usually for 10-14 days. Along with the antibiotic, your ENT doctor may prescribe over-the-counter medications and prescription medications to help decrease the severity and duration of your symptoms.
For chronic sinusitis, the treatment is a bit more complicated, as it requires a more prolonged duration of medical therapy (a combination of medications as discussed above). The choice of antibiotic will depend on the result of sinus cultures (a test that uses a sample of a patient’s mucus to determine which bacteria are present), and once prescribed, your ENT doctor will have you take it for 3-4 weeks time.
Whether you have acute or chronic rhinosinusitis, your ENT doctor will want to follow up with you in a few weeks after starting treatment to see how the medication is working to alleviate your symptoms.