From the Guidelines
Treatment for a sinus infection typically involves a combination of medications and home remedies, with antibiotics reserved for patients with persistent symptoms for more than 10 days, onset of severe symptoms or signs of high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving. For mild to moderate sinus infections, start with over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation 1. Decongestants such as pseudoephedrine (Sudafed) can help reduce nasal congestion, but shouldn't be used for more than 3 days to avoid rebound congestion. Saline nasal sprays or rinses like neti pots can flush out mucus and allergens; use these 2-3 times daily with distilled or boiled water.
Some key points to consider when treating sinus infections include:
- Most sinus infections are viral and will resolve within 7-10 days without antibiotics 1
- Antibiotics may be necessary for bacterial sinus infections, with amoxicillin (500mg three times daily for 5-10 days) or amoxicillin-clavulanate (875mg twice daily for 5-10 days) commonly prescribed 1
- During recovery, stay hydrated, rest with your head elevated, apply warm compresses to your face, and breathe in steam from a hot shower to help loosen mucus
- If symptoms persist beyond 10 days, worsen after initial improvement, or include high fever, severe pain, or changes in vision, seek medical attention as you may need prescription treatment or have a more serious condition 1
It's also important to note that acute uncomplicated rhinosinusitis is a self-limited infection that usually resolves without antibiotics, even in patients with a bacterial cause, and most patients diagnosed with acute rhinosinusitis have more adverse effects than benefits from antibiotics 1.
From the Research
Treatment Options for Sinus Infection
- The combination of paracetamol and pseudoephedrine has been shown to be effective in treating nasal congestion and pain-related symptoms in upper respiratory tract infections, including sinus infections 2.
- A study published in 2006 found that a single dose of the combination was superior to paracetamol and placebo for nasal airflow conductance and was superior to pseudoephedrine and placebo for pain relief 2.
- Multiple doses of the combination were also found to be superior to paracetamol and placebo for decongestion and were superior to pseudoephedrine and placebo for pain reduction 2.
Benefits and Risks of Pseudoephedrine
- Pseudoephedrine is a drug with a long history of medical use, helpful in treating symptoms of the common cold and flu, sinusitis, asthma, and bronchitis 3.
- However, due to its central nervous system stimulant properties and structural similarity to amphetamine, it is also used for non-medical purposes, such as an appetite reducer, an agent to eliminate drowsiness and fatigue, and to improve concentration 3.
- Pseudoephedrine is also a substrate used in the production of amphetamine or methamphetamine, and its easier availability has led to its misuse as a substitute for these drugs 3.