From the Research
A sinus abscess requires immediate medical attention, and treatment typically involves a combination of antibiotics and possibly surgical drainage, with amoxicillin being a viable option for adults with acute sinusitis, as shown in a recent study 1.
Treatment Overview
The treatment of a sinus abscess involves a combination of antibiotics and possibly surgical drainage. For adults, empiric antibiotic therapy often includes intravenous broad-spectrum antibiotics such as ampicillin-sulbactam or clindamycin plus ceftriaxone for 7-10 days, followed by oral antibiotics to complete a 2-3 week course.
- Antibiotic options: ampicillin-sulbactam (3g IV every 6 hours) or clindamycin (600mg IV every 8 hours) plus ceftriaxone (2g IV daily)
- Surgical drainage is necessary if the abscess is large, causing significant symptoms, or not responding to antibiotics within 24-48 hours
- The procedure involves making an incision to drain the pus collection and may be performed by an ENT specialist or ophthalmologist depending on the location
Diagnosis and Management
Sinus abscesses develop when bacterial infections in the sinuses spread to surrounding tissues, creating a pocket of pus. These infections can rapidly progress and potentially spread to the brain or bloodstream if untreated, which is why aggressive treatment is essential.
- Diagnosis is typically clinical, with symptoms such as unilateral facial pain or pressure, fever, and purulent nasal discharge
- Diagnostic testing, such as computed tomography, may be necessary to confirm the diagnosis and rule out complications
- Supportive care, including saline nasal rinses, pain management with acetaminophen or ibuprofen, and warm compresses, may provide symptomatic relief
Recent Evidence
A recent study published in 2021 found that amoxicillin is as effective as amoxicillin-clavulanate for the treatment of acute sinusitis in adults, with fewer gastrointestinal-related adverse events 1.
- This study suggests that amoxicillin may be a viable option for adults with acute sinusitis, including those with a sinus abscess
- Another study published in 2025 provides a rapid evidence review of acute rhinosinusitis, highlighting the importance of distinguishing between bacterial and viral sinusitis, and the use of antibiotics in patients with severe symptoms or significant worsening of symptoms 2