Best Antibiotics for Sinus Infection (2024)

Sinus infections can be frustrating, painful, and prolonged. These infections of the sinus cavities in the skull are very similar to the common cold but often last longer and cause more pain. If you are experiencing a sinus infection, you want to get rid of it as fast as possible. We get that.
Most sinus infections are caused by viruses, meaning that, like the common cold, you just need to wait the infection out. A viral sinus infection will go away on its own, but you can minimize your discomfort with pain relievers and other forms of therapy. However, bacteria may less frequently be the cause of a sinus infection. Bacterial sinus infections require prescription medication to neutralize the invasive pathogens and prevent them from traveling to other parts of the body. In this article, we’ll look at your best antibiotic treatment options and whether or not this is the proper treatment for you.

What is a sinus infection?

A sinus infection—sinusitis or rhinosinusitis—is an infection of the sinus cavities. The sinus cavities are air-filled spaces behind the nose, cheekbones, and forehead. These cavities are lined with tissue that can become inflamed and swollen when infected. This can lead to the hallmark symptoms of a sinus infection, like nasal congestion, facial pain, and post-nasal drip. The head pressure associated with a sinus infection is usually intensified when leaning forward or palpating over the sinuses.

A viral infection usually causes sinus infections. Viruses, bacteria, or fungi are the primary causes of acute sinusitis. An allergic reaction may also cause these sinuses. Acute sinus infections will go away within a few days with the help of medication and home remedies.

Chronic sinusitis is a persistent inflammation of the sinuses. An infection can cause chronic sinus infections, nasal polyps (abnormal growths in the nasal passages), a deviated septum, or other underlying health problems caused by a compromised immune system.

Infections of the sinus cavities are widespread. In 2018, the Centers for Disease Control and Prevention (CDC) reported that 28.9 million adults were diagnosed with sinusitis. These cases range in severity, but sinus infections did account for 2.7 million health care provider visits across the country.

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Common symptoms of a sinus infection include:

• Nasal congestion/ stuffy nose
  
• Runny nose (nasal discharge)
  
• Facial pain
  
• Sinus pain
  
• Headaches
  
• Toothaches
  
• Upper jaw pain
  
• Bad breath
  
• Decreased sense of smell
  
• Sore throat
  
• Fever

These signs resemble upper respiratory tract infections, such as the common cold. Sinus infections rarely cause coughing or body aches, as upper respiratory infections do. In addition, infections of the sinus cavities will often produce thicker mucus as well as more facial pain and headache symptoms than a common cold.

What is a Bacterial Sinus Infection?

Bacterial sinus infections (bacterial sinusitis) are sinus infections caused by harmful bacteria. When blockage or congestion occurs in the sinus cavities, bacteria can breed in the built-up mucus. This bacteria then spreads and infects the surrounding sinus cavities.

If you have had a sinus infection for over ten days, you likely have a bacterial sinus infection. A bacterial infection requires antimicrobial—specifically, antibiotic—treatment to eliminate the infection.

Do I Need Antibiotics for a Sinus Infection?

If you are experiencing a bacterial sinus infection, yes. Viral sinus infections will go away on their own after a week or so. On the other hand, bacterial infections require a course of antibiotic treatment to rid the body of harmful microbes and prevent further spread. While antibiotics are not commonly used for treating sinus infections, they should be used when bacteria are causing the condition.

It is important to note that you should not use antibiotics to treat a viral sinus infection or other forms of viral infectious diseases. Misuse of antibiotic medication can lead to serious side effects and antibiotic resistance. Certain bacteria carry a gene that makes them resistant to antibiotic medicines. If you use antibiotic drugs when you don’t need to, this gene could become active, making the invasive bacteria immune to treatment. This can make it significantly more challenging to treat a bacterial infection. Because of this, antibiotic use is reserved only for diagnosed bacterial infections.

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What Are the Best Antibiotics for Bacterial Sinus Infections?

In the rare instance that you need antibiotic medication to treat your sinus infection, there are several options that the prescribing provider can choose to use.

Some of the most common and effective forms of antibiotic treatment for bacterial sinus infections include:

Amoxicillin: Amoxicillin, a penicillin-like drug, is generally supplied as an oral tablet. This antibiotic neutralizes invasive bacteria, preventing their spread to other body parts. Amoxicillin has been shown to cause side effects like nausea, vomiting, headaches, and diarrhea.

Amoxicillin-clavulanate (Augmentin): Amoxicillin and potassium clavulanate are used to treat infections caused by bacteria that are presumably resistant to treatment with amoxicillin alone. Amoxicillin-resistant infections may include sinus infections. Clavulanate helps prevent bacteria from destroying amoxicillin. This drug has been shown to cause side effects such as diarrhea, vomiting, and an upset stomach.

For those with a penicillin allergy, a prescribing health care provider may opt to use other forms of antibiotic treatment, such as doxycycline, levofloxacin, or moxifloxacin.

Can a Z-Pack Treat a Sinus Infection?

Z-Packs are a 5-day course of antibiotic treatment containing the drug azithromycin. Azithromycin is used to treat many bacterial infections, including sexually transmitted diseases (like chlamydia and gonorrhea) and upper respiratory infections like bronchitis and pneumonia.

Z-Packs are not recommended for sinus infections, as azithromycin induces antibiotic resistance. According to the CDC, 1 out of 3 antibiotic prescriptions written by doctors isn’t even necessary for treatment. Prescribing antibiotics when unnecessary can cause antibiotic resistance and even more severe side effects. Because of this, clinical practice guidelines recommends amoxicillin use over the use of Z-Packs and azithromycin as a treatment for bacterial sinus infections.

What OTC treatment options exist?

Some estimates suggest that over 90% of sinus infections are caused by a virus. This means that antibiotic treatment is not only ineffective but also dangerous. Viral sinus infections will go away on their own over time. While waiting for the infection to heal, you can use several OTC and home remedies to start feeling better. These include:

OTC Medication

These drugs are widely available at pharmacies and medical supply retailers.

Standard over-the-counter treatment options include:

Saline nasal spray: Over-the-counter saline nasal sprays (like Sinex) are widely available at most pharmacies. These sprays rinse and clean the nasal passages, which can reduce symptoms.

Steroid nasal sprays: Nasal sprays containing the steroid fluticasone (Flonase) can help reduce inflammation caused by sinus infections. Soothing inflammation can reduce symptoms of facial pain, headaches, and congestion.

Decongestants: Decongestant medications containing pseudoephedrine (like Sudafed) are available over the counter as nasal sprays, oral liquids or tablets. Decongestants clear up the mucus blockage in the nasal passages, reducing facial pressure and nasal discharge symptoms. You should only use a nasal decongestant for a few days, as repeated use can cause more serious congestion.

OTC Pain Relievers: Pain relievers such as ibuprofen and acetaminophen can help minimize body aches, sinus pain and fever symptoms caused by these conditions. Although they won't help with a runny or stuffy nose, these medications will ease the discomfort associated with an upper respiratory viral infection.

Home remedies

In addition to the medication listed above, you can use simple home remedies to clear up your sinus symptoms and encourage healing.

At-home remedies include:

Neti Pots: Neti Pots are common appliances used for nasal irrigation. To use one, put iodide and preservative-free salt water into the chamber. It is recommended that you boil the water first to sanitize it. Wait until the water is room temperature before you put it in the Neti Pot. Pour the solution into each nostril, per the device’s instructions. This salt water rinse can help reduce congestion and pain caused by a sinus infection while cleansing the affected area.

Moisten sinus cavities: Drape a towel over your head and breathe in the vapor from a bowl of hot water. This helps moisturize the nose, drain mucus and relieve sinus infection symptoms. Alternatively, take a hot shower and inhale the warm, wet air. Use a humidifier at night, but make sure you use filtered water in the chamber.

Warm compress: A warm compress applied to your nose and forehead may help alleviate sinus congestion.

Sources:

• CDC. Sinus Infection (Sinusitis). cdc.gov. 2019.
  
• Harvard Health. When do you really need antibiotics for that sinus infection? health.harvard.edu. 2016.
  
• Mayo Clinic. Will my sinus infection clear up on its own? mayoclinichealthsystem.org. 2022.