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Treatments and drugs
By Mayo Clinic staffMost cases of acute sinusitis don't need treatment because they are caused by cold viruses. Self-care techniques are usually the only treatment needed to speed recovery and ease symptoms.
Treatments to relieve symptoms
Your doctor may recommend treatments to help relieve sinusitis symptoms, including:
- Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
- Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ).
- Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. OTC oral decongestants include Sudafed, Actifed and Drixoral. Nasal sprays include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). These medications are generally taken for only a few days at most. Otherwise they can cause the return of more severe congestion (rebound congestion).
- Over-the-counter pain relievers such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). Because of the risk of Reye's syndrome — a potentially life-threatening illness — never give aspirin to children.
Antibiotics
Antibiotics usually aren't needed to treat acute sinusitis.
- Antibiotics won't help when acute sinusitis is caused by a viral or fungal infection.
- Most cases of bacterial sinusitis improve without antibiotics.
- Antibiotic treatment is generally needed only if you have a severe, recurrent or persistent bacterial infection.
Antibiotics used to treat acute sinusitis caused by a bacterial infection include amoxicillin (Amoxil, Trimox, others), doxycycline (Doryx, Monodox, others) or the combination drug trimethoprim-sulfamethoxazole (Bactrim, Septra, others). If the infection doesn't go away or if the sinusitis comes back, your doctor may try a different antibiotic.
If your doctor does prescribe antibiotics, it's critical to take the entire course of medication. Generally, this means you'll need to take them for 10 to 14 days — even after your symptoms get better. If you stop taking them early, your symptoms may come back.
Antifungal medications
Rarely, acute sinusitis is caused by a fungal infection. You may need an intravenous (IV) medication such as amphotericin B or voriconazole. The dose of medication — as well as how long you'll need to take it — depends on the severity of your infection and how quickly your symptoms improve.
Immunotherapy
If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens may help treat your symptoms.
- Hwang P, et al. Acute sinusitis and rhinosinusitis in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 16, 2008.
- Leung R, et al. The diagnosis and management of acute and chronic sinusitis. Primary Care. 2008;35:11-24.
- Joint Task Force on Practice Parameters for Allergy and Immunology. The diagnosis and management of sinusitis: A practice parameter update. Journal of Allergy and Clinical Immunology. 2005;116(6)(suppl):13-47.
- Fungal sinusitis. http://www.uptodate.com/home/index.html. Accessed Sept. 16, 2008.
