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Sinusitis: Should I Take Antibiotics?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Sinusitis: Should I Take Antibiotics?

Get the facts

Your options

  • Take antibiotics to treat sinusitis.
  • Don't take antibiotics. Try other medicines and home treatment instead.

Key points to remember

  • Sinusitis is an infection or inflammation of the lining of the sinuses. Most people who get sinusitis have a cold first. Sinusitis usually goes away on its own.
  • Sinusitis is usually caused by a virus, so antibiotics won't help. Over-the-counter medicines and home treatment can help you feel better.
  • Antibiotics do work if sinusitis is caused by bacteria. But you may not need to take them. Most people get better even if they don't take antibiotics.
  • Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance.
  • Antibiotics have side effects. The most common ones include upset stomach, diarrhea, and belly pain. Antibiotics can also lead to vaginal yeast infections.
FAQs

What is sinusitis?

Sinusitis is an infection or inflammation in the mucous membranes that line the sinus cavities. Most of the time, sinusitis is caused by a virus. But it can also be caused by bacteria. Most people who get sinusitis have a cold first. Sinusitis can cause pain and pressure in your head and face.

There are two types of sinusitis:

  • Acute (short-term). Acute sinusitis is usually caused by a virus. It can last for 2 to 4 weeks. Symptoms often start to clear up on their own in 10 to 14 days.
  • Chronic (long-term). Chronic sinusitis is usually caused by bacteria. Sometimes it is caused by a fungus. It can last for 12 weeks or longer and can be hard to treat.

How is sinusitis treated?

Your treatment will depend on the cause of your sinusitis. Most of the time, treatment includes medicines and taking care of yourself at home. Medicines that are used most often include:

  • Decongestants, such as Sudafed, that are taken as pills or liquids. These can reduce swelling and improve sinus drainage.
  • Over-the-counter pain medicine, such acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil).
  • Antibiotics, which kill bacteria. Antibiotics will only work if your sinusitis is caused by bacteria. Most of the time, sinusitis is caused by a virus.

How do you know if your sinusitis is caused by bacteria?

You may have a bacterial infection in your sinuses if:

  • You have pain in your cheeks or upper back teeth and a high fever that doesn't go away.
  • You have a lot of bright yellow or green drainage from your nose for more than 10 days.
  • Decongestants do not relieve your pain.
  • Your symptoms get worse instead of better after your cold is gone.

How well do antibiotics work for sinusitis?

Antibiotics work in most cases of acute sinusitis that are caused by bacteria. Most people start feeling better 3 to 4 days after they start taking the medicine.

Antibiotics won't work for infections caused by a virus. Over-the-counter medicines and home treatment can help you feel better.

What are the risks of antibiotics?

Taking antibiotics you don't need won't help you feel better, cure your infection, or keep others from catching your infection. And if you take antibiotics too often, they may not work when you really do need them.

Common but mild side effects of antibiotics include:

If you do take antibiotics, take them as directed. Keep taking them even after you start to feel better. The infection may not go away if you don't take all of the medicine your doctor prescribes.

How can you treat sinusitis without antibiotics?

Whether sinusitis is caused by bacteria or by a virus, most people get better even if they don't take antibiotics.1 Home treatment for sinusitis can help relieve your symptoms. Here are some things you can do:

  • Drink plenty of fluids to thin your mucus.
  • Apply moist heat (using a hot, damp towel or gel pack) to your face for 5 to 10 minutes. Do this at least 3 times a day.
  • Breathe warm, moist air from a steamy shower, a hot bath, or a sink filled with hot water.
  • Use saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria. You can buy saline nose drops or sprays at a pharmacy or make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled. You may also find it helpful to gargle with warm salt water.
  • Use over-the-counter medicines such as pain relievers and decongestants to help you feel better.
  • If you need to blow your nose, do it gently. Blowing your nose too hard may force thick mucus back into your sinuses. Keep both nostrils open when you blow your nose.

Why might your doctor recommend antibiotics for sinusitis?

You doctor may recommend antibiotics if:

  • You have symptoms of a bacterial infection and you have not gotten better after 10 days, even with home treatment.
  • Your symptoms are severe, or you have other problems, such as pus forming in your sinus cavities.
  • You have had sinusitis for 12 weeks or longer (chronic sinusitis).

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take antibiotics to treat sinusitis Take antibiotics to treat sinusitis
  • You take antibiotics to kill a bacterial infection.
  • You may need to take a different antibiotic if the first one doesn't work.
  • How long you take antibiotics depends on your health, how bad your infection is, and the kind of antibiotic you take.
  • You may also take other medicines to help sinus drainage.
  • If your sinusitis is caused by bacteria, you will start to feel better in 3 to 4 days.
  • Antibiotics are effective for bacterial infections.
  • Side effects of antibiotics include a bad taste in the mouth, upset stomach, diarrhea, and vaginal yeast infection.
  • Taking antibiotics you don't need won't help you feel better, cure your infection, or keep others from catching your infection.
  • If you take antibiotics too often, the medicine may not work the next time you take it when you really do need it.
Don't take antibiotics Don't take antibiotics
  • You use over-the-counter medicines such as pain relievers and decongestants to feel better.
  • You try home treatment, such as:
    • Drinking plenty of fluids.
    • Applying moist heat to your face for 5 to 10 minutes at least 3 times a day.
    • Breathing warm, moist air from a steamy shower or hot bath.
    • Trying saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria.
  • Most people get better on their own in 10 to 14 days.
  • You avoid the risks of antibiotics.
  • Your sinus infection may not get better on its own.
  • Your sinus infection may get worse.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about antibiotics for sinusitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I've had sinusitis a few times. So when my doctor suggested I take an antibiotic, I asked him if I really needed it. He said I would probably get better faster if I took the medicine. But I know from the other times that I'll probably be okay in a week or so anyway. So we decided to wait and see instead of trying antibiotics.

Maria, age 34

I can't wait to feel better. It seems like I've had bad sinus pain for the longest time. It's been at least 2 weeks. Nasal sprays aren't helping. I'm going to ask my doctor for antibiotics.

David, 28

I thought I just had a bad cold, but my doctor says I have sinusitis caused by a bacterial infection. I've been doing all the right things at home, but it isn't going away. I think antibiotics are the next step for me.

Carmen, 50

I thought I'd get my doctor to give me some antibiotics for my sinusitis. Then I'd be over it sooner. But it turns out that antibiotics won't help me, since my sinusitis started as a cold. I didn't know that antibiotics don't always work. I'm going to wait it out instead.

John, age 52

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics for sinusitis

Reasons not to take antibiotics

I know I have a bacterial infection that is causing my sinusitis.

A virus is causing my sinusitis.

More important
Equally important
More important

I've tried home treatment, but it has not helped.

I want to try home treatment and other medicines first.

More important
Equally important
More important

The side effects of antibiotics don't bother me.

I'm worried about the side effects of antibiotics.

More important
Equally important
More important

I want to take medicine if it will help me get better faster.

I don't want to take medicine that I might not need if I'll get better soon anyway.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antibiotics

NOT taking antibiotics

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Is sinusitis most often caused by a virus?

  • YesYou are right. Most of the time, sinusitis is caused by a virus, and antibiotics don't work against a virus.
  • NoSorry, that's not right. Most of the time, sinusitis is caused by a virus, and antibiotics don't work against a virus.
  • I'm not sureIt may help to go back and read "Get the Facts." Most of the time, sinusitis is caused by a virus, and antibiotics don't work against a virus.
2.

Is it okay to take antibiotics anytime you think they might help, even if you may not really need them?

  • YesSorry, that's not right. Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it.
  • NoYou're right. Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it.
  • I'm not sureIt may help to go back and read "Get the Facts." Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it.
3.

Can antibiotics treat sinusitis that is caused by bacteria?

  • YesYou're right. Antibiotics can treat short-term sinusitis when it is caused by bacteria. But many people get better even without antibiotics.
  • NoSorry, that's not right. Antibiotics can treat short-term sinusitis when it is caused by bacteria. But many people get better even without antibiotics.
  • I'm not sureIt may help to go back and read "Get the Facts." Antibiotics can treat short-term sinusitis when it is caused by bacteria. But many people get better even without antibiotics.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
Credits Healthwise Staff
Primary Medical Reviewer Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer Donald R. Mintz, MD - Otolaryngology

References
Citations
  1. Ah-See K (2011). Sinusitis (acute), search date June 2011. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Sinusitis: Should I Take Antibiotics?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Take antibiotics to treat sinusitis.
  • Don't take antibiotics. Try other medicines and home treatment instead.

Key points to remember

  • Sinusitis is an infection or inflammation of the lining of the sinuses. Most people who get sinusitis have a cold first. Sinusitis usually goes away on its own.
  • Sinusitis is usually caused by a virus, so antibiotics won't help. Over-the-counter medicines and home treatment can help you feel better.
  • Antibiotics do work if sinusitis is caused by bacteria. But you may not need to take them. Most people get better even if they don't take antibiotics.
  • Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance.
  • Antibiotics have side effects. The most common ones include upset stomach, diarrhea, and belly pain. Antibiotics can also lead to vaginal yeast infections.
FAQs

What is sinusitis?

Sinusitis is an infection or inflammation in the mucous membranes that line the sinus cavities . Most of the time, sinusitis is caused by a virus. But it can also be caused by bacteria. Most people who get sinusitis have a cold first. Sinusitis can cause pain and pressure in your head and face.

There are two types of sinusitis:

  • Acute (short-term). Acute sinusitis is usually caused by a virus. It can last for 2 to 4 weeks. Symptoms often start to clear up on their own in 10 to 14 days.
  • Chronic (long-term). Chronic sinusitis is usually caused by bacteria. Sometimes it is caused by a fungus. It can last for 12 weeks or longer and can be hard to treat.

How is sinusitis treated?

Your treatment will depend on the cause of your sinusitis. Most of the time, treatment includes medicines and taking care of yourself at home. Medicines that are used most often include:

  • Decongestants, such as Sudafed, that are taken as pills or liquids. These can reduce swelling and improve sinus drainage.
  • Over-the-counter pain medicine, such acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil).
  • Antibiotics, which kill bacteria. Antibiotics will only work if your sinusitis is caused by bacteria. Most of the time, sinusitis is caused by a virus.

How do you know if your sinusitis is caused by bacteria?

You may have a bacterial infection in your sinuses if:

  • You have pain in your cheeks or upper back teeth and a high fever that doesn't go away.
  • You have a lot of bright yellow or green drainage from your nose for more than 10 days.
  • Decongestants do not relieve your pain.
  • Your symptoms get worse instead of better after your cold is gone.

How well do antibiotics work for sinusitis?

Antibiotics work in most cases of acute sinusitis that are caused by bacteria. Most people start feeling better 3 to 4 days after they start taking the medicine.

Antibiotics won't work for infections caused by a virus. Over-the-counter medicines and home treatment can help you feel better.

What are the risks of antibiotics?

Taking antibiotics you don't need won't help you feel better, cure your infection, or keep others from catching your infection. And if you take antibiotics too often, they may not work when you really do need them.

Common but mild side effects of antibiotics include:

If you do take antibiotics, take them as directed. Keep taking them even after you start to feel better. The infection may not go away if you don't take all of the medicine your doctor prescribes.

How can you treat sinusitis without antibiotics?

Whether sinusitis is caused by bacteria or by a virus, most people get better even if they don't take antibiotics.1 Home treatment for sinusitis can help relieve your symptoms. Here are some things you can do:

  • Drink plenty of fluids to thin your mucus.
  • Apply moist heat (using a hot, damp towel or gel pack) to your face for 5 to 10 minutes. Do this at least 3 times a day.
  • Breathe warm, moist air from a steamy shower, a hot bath, or a sink filled with hot water.
  • Use saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria. You can buy saline nose drops or sprays at a pharmacy or make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled. You may also find it helpful to gargle with warm salt water.
  • Use over-the-counter medicines such as pain relievers and decongestants to help you feel better.
  • If you need to blow your nose, do it gently. Blowing your nose too hard may force thick mucus back into your sinuses. Keep both nostrils open when you blow your nose.

Why might your doctor recommend antibiotics for sinusitis?

You doctor may recommend antibiotics if:

  • You have symptoms of a bacterial infection and you have not gotten better after 10 days, even with home treatment.
  • Your symptoms are severe, or you have other problems, such as pus forming in your sinus cavities.
  • You have had sinusitis for 12 weeks or longer (chronic sinusitis).

2. Compare your options

  Take antibiotics to treat sinusitis Don't take antibiotics
What is usually involved?
  • You take antibiotics to kill a bacterial infection.
  • You may need to take a different antibiotic if the first one doesn't work.
  • How long you take antibiotics depends on your health, how bad your infection is, and the kind of antibiotic you take.
  • You may also take other medicines to help sinus drainage.
  • You use over-the-counter medicines such as pain relievers and decongestants to feel better.
  • You try home treatment, such as:
    • Drinking plenty of fluids.
    • Applying moist heat to your face for 5 to 10 minutes at least 3 times a day.
    • Breathing warm, moist air from a steamy shower or hot bath.
    • Trying saltwater nasal washes to help keep your nasal passages open and to wash out mucus and bacteria.
What are the benefits?
  • If your sinusitis is caused by bacteria, you will start to feel better in 3 to 4 days.
  • Antibiotics are effective for bacterial infections.
  • Most people get better on their own in 10 to 14 days.
  • You avoid the risks of antibiotics.
What are the risks and side effects?
  • Side effects of antibiotics include a bad taste in the mouth, upset stomach, diarrhea, and vaginal yeast infection.
  • Taking antibiotics you don't need won't help you feel better, cure your infection, or keep others from catching your infection.
  • If you take antibiotics too often, the medicine may not work the next time you take it when you really do need it.
  • Your sinus infection may not get better on its own.
  • Your sinus infection may get worse.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about antibiotics for sinusitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I've had sinusitis a few times. So when my doctor suggested I take an antibiotic, I asked him if I really needed it. He said I would probably get better faster if I took the medicine. But I know from the other times that I'll probably be okay in a week or so anyway. So we decided to wait and see instead of trying antibiotics."

— Maria, age 34

"I can't wait to feel better. It seems like I've had bad sinus pain for the longest time. It's been at least 2 weeks. Nasal sprays aren't helping. I'm going to ask my doctor for antibiotics."

— David, 28

"I thought I just had a bad cold, but my doctor says I have sinusitis caused by a bacterial infection. I've been doing all the right things at home, but it isn't going away. I think antibiotics are the next step for me."

— Carmen, 50

"I thought I'd get my doctor to give me some antibiotics for my sinusitis. Then I'd be over it sooner. But it turns out that antibiotics won't help me, since my sinusitis started as a cold. I didn't know that antibiotics don't always work. I'm going to wait it out instead."

— John, age 52

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics for sinusitis

Reasons not to take antibiotics

I know I have a bacterial infection that is causing my sinusitis.

A virus is causing my sinusitis.

             
More important
Equally important
More important

I've tried home treatment, but it has not helped.

I want to try home treatment and other medicines first.

             
More important
Equally important
More important

The side effects of antibiotics don't bother me.

I'm worried about the side effects of antibiotics.

             
More important
Equally important
More important

I want to take medicine if it will help me get better faster.

I don't want to take medicine that I might not need if I'll get better soon anyway.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antibiotics

NOT taking antibiotics

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Is sinusitis most often caused by a virus?

  • Yes
  • No
  • I'm not sure
You are right. Most of the time, sinusitis is caused by a virus, and antibiotics don't work against a virus.

2. Is it okay to take antibiotics anytime you think they might help, even if you may not really need them?

  • Yes
  • No
  • I'm not sure
You're right. Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it.

3. Can antibiotics treat sinusitis that is caused by bacteria?

  • Yes
  • No
  • I'm not sure
You're right. Antibiotics can treat short-term sinusitis when it is caused by bacteria. But many people get better even without antibiotics.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

 
Credits
By Healthwise Staff
Primary Medical Reviewer Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer Donald R. Mintz, MD - Otolaryngology

References
Citations
  1. Ah-See K (2011). Sinusitis (acute), search date June 2011. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Last Revised: September 12, 2012

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