From the Guidelines
Treatment options for sinus drainage should prioritize saline nasal irrigation and topical intranasal corticosteroids for symptom relief, as recommended by the most recent and highest quality study 1.
Overview of Treatment Options
- Saline nasal sprays or rinses, such as NeilMed Sinus Rinse or a neti pot with sterile water, can flush out mucus and irritants.
- Over-the-counter decongestants like pseudoephedrine (Sudafed) can provide temporary relief for 3-5 days, but should not be used longer due to rebound congestion risk.
- Antihistamines like loratadine (Claritin) or cetirizine (Zyrtec) at 10mg daily can help if allergies are causing drainage.
- Nasal steroid sprays such as fluticasone (Flonase) or mometasone (Nasonex), used as 1-2 sprays per nostril daily, reduce inflammation and can be used long-term.
Additional Considerations
- For severe cases, a doctor might prescribe antibiotics if bacterial infection is present, or oral steroids for significant inflammation, as outlined in 1.
- Simple home measures like staying hydrated, using a humidifier, applying warm compresses to the face, and elevating the head while sleeping can also provide relief.
- Surgical intervention may be considered in cases of recurrent or chronic sinusitis, particularly when there are anatomic defects or obstructing nasal polyps, as discussed in 1 and 1.
Key Recommendations
- Clinicians should recommend saline nasal irrigation, topical intranasal corticosteroids, or both for symptom relief of chronic rhinosinusitis, as stated in 1.
- The choice of antibiotic for acute bacterial rhinosinusitis should be based on predicted efficacy, cost, and side effects, with amoxicillin with or without clavulanate as first-line therapy for 5 to 10 days, as recommended in 1.
From the FDA Drug Label
■ temporarily relieves sinus congestion and pressure • temporarily relieves sinus congestion and pressure The treatment options for sinus drainage include:
- Phenylephrine (PO): temporarily relieves sinus congestion and pressure 2
- Pseudoephedrine (PO): temporarily relieves sinus congestion and pressure 3
From the Research
Treatment Options for Sinus Drainage
- Sinus drainage can be treated with various methods, including removal of pus in subacute or chronic maxillary sinusitis through anterior maxillary sinus puncture, as recommended by 4
- For allergic rhinitis and nasal congestion, a combination of desloratadine and pseudoephedrine can be an effective treatment, improving nasal congestion scores and quality of life 5
- Corticosteroids may be used to treat sinusitis, although studies have shown no clear advantage in using steroids, and no significant reduction in the effectiveness of antibiotic therapy was seen with concurrent steroid use 6
- Treatment for acute sinusitis includes symptomatic relief with analgesics, topical or systemic decongestants, and steam inhalation, while chronic sinusitis may require long-term use of topical corticosteroids, mast cell stabilisers, or antihistamines 7
- Nasal decongestants, such as topical or oral sympathomimetics, can provide immediate relief for nasal obstruction, but should be used with caution and for a limited time to avoid risks and side effects 8
Medical Treatment
- Antibiotics may be prescribed for acute sinusitis, and should be taken for an adequate period of time 7
- Topical corticosteroids can help control rhinitis and improve ventilation and function of the sinuses 7
- Antihistamines and mast cell stabilisers can also be used to control rhinitis and alleviate symptoms of sinusitis 7