Continued Use of Steroid Nasal Spray During Sinus Infection
Yes, patients should continue using steroid nasal spray during a sinus infection, as it helps reduce inflammation and may improve outcomes without interfering with treatment of the infection. 1
Rationale for Continued Use
Intranasal corticosteroids (INCS) are beneficial during sinus infections for several reasons:
- They reduce mucosal inflammation, which can help improve nasal patency and sinus drainage
- They may enhance the effectiveness of other treatments by improving medication delivery to the affected areas
- They help manage underlying conditions (like allergic rhinitis) that may contribute to sinus infections
The European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) supports the continued use of intranasal corticosteroids during sinus infections 1.
Proper Administration Technique
For maximum effectiveness and safety, advise your patient to use the following technique:
- Prime the bottle before first use
- Shake the bottle before each use (especially important for suspension formulations)
- Blow nose prior to using the spray
- Keep head in upright position during administration
- Hold the spray in the opposite hand relative to the nostril being treated (to direct spray away from septum)
- Breathe in gently during spraying
- Do not close the opposite nostril 1
Important Considerations
Timing with Other Treatments
If your patient is also using nasal saline irrigations, instruct them to:
- Perform saline irrigation first
- Wait a few minutes
- Then use the steroid nasal spray 1
This sequence prevents washing out the medication.
Expectations for Effectiveness
Inform your patient that:
- Initial effects may begin within 12 hours
- Maximum efficacy may take days to weeks to achieve
- Regular, consistent use is necessary for optimal results 1
Monitoring for Side Effects
While continuing the steroid nasal spray, monitor for:
- Nasal irritation or bleeding (most common side effect)
- Direct spray away from septum to minimize risk of septal perforation 1
- Periodic examination of the nasal septum is recommended to check for mucosal erosions 1
Special Situations
If symptoms persist despite appropriate treatment with intranasal corticosteroids, consider:
- Checking administration technique
- Evaluating adherence to therapy
- Referral to an ENT specialist if symptoms remain uncontrolled 1
Bottom Line
Intranasal corticosteroids should be continued during sinus infections as they help reduce inflammation and improve symptoms without compromising treatment of the infection. Proper administration technique and regular use are essential for optimal effectiveness.