A sinus infection can be treated with antibiotics when it is caused by bacteria. Sinus infections that have other causes, such as allergies or viruses, will not benefit from antibiotics.
Most sinus infections don’t need antibiotics and will start to get better without treatment. Health care providers usually only prescribe antibiotics for sinus infections that don’t go away on their own.
This article looks at what types of sinus infections can be treated with antibiotics. It also discusses over-the-counter treatments and home remedies.
When antibiotics are needed
Historically, sinus infections, also called sinusitis, were often treated with antibiotics. But today, many allergists warn against randomly using antibiotics for a sinus infection.
Antibiotics can help clear up bacterial sinus infections. But when a sinus infection is caused by allergies, a virus, or other causes such as a structural defect in the sinuses, an antibiotic won’t help relieve symptoms.
Overuse of antibiotics is when they are prescribed for reasons other than when they are needed. Due to the common over-prescription of antibiotics for the type of sinus infections that do not warrant such treatment, many people have developed what is commonly referred to as antibiotic resistance.
When does antibiotic resistance occur?
Antibiotic resistance occurs in a person’s own body and within the community when certain drugs no longer work for a specific type of germ. This can happen when the bacteria change in response to exposure to antibiotics so that the antibiotics no longer work effectively against the bacteria.
Unfortunately, it’s hard to tell if a sinus infection is bacterial, viral, or has other causes based on symptoms alone. Since viral sinus infections tend to get better in 5 to 7 days, healthcare providers will usually only prescribe antibiotics if your symptoms last longer than that. A sinus infection that persists for more than a week or continues to worsen during that time is more likely to be bacterial.
Therefore, allergists and other specialists recommend limiting the use of antibiotics unless:
- Symptoms last more than seven to 10 days
- A fever (which may indicate a bacterial infection) is present
Common antibiotics for sinus infections
Antibiotics may be prescribed when symptoms of a sinus infection warrant such treatment. Common antibiotics for sinus infection include:
- Augmentin (amoxicillin/clavulanic acid)
- Zithromax (azithromycin)
- Levaquin (levofloxacin): Although this drug is often prescribed as a first-line treatment for sinusitis, it has serious side effects and should only be used as a last resort.
- Septra (trimethoprim-sulfamethoxazole)
- Amoxil (amoxicillin)
Symptoms of a Sinus Infection
Symptoms of a sinus infection are caused by blockage of the sinuses, which are hollow air spaces in the nasal area. When your sinuses are inflamed, the area becomes blocked with fluid, causing pain and, in some cases, allowing bacteria to grow.
Common symptoms of a sinus infection include:
- Sinus pain around the bridge of the nose or under the eyes
- Pain in the upper jaw and teeth
- Headache around the forehead or temples that gets worse in the morning after sinus drainage has built up overnight
- Post-nasal secretions
- Runny nose that is not clear
- Nasal congestion
- Facial tenderness
- Cough (at night after lying down or in the morning)
- Hoarseness and sore throat
- bad breath
Before prescribing an antibiotic, your health care provider may suggest an over-the-counter treatment for a sinus infection. These may include:
- Nasal decongestants and antihistamines: There are several combination medications available over-the-counter, but be sure to consult your allergist, pharmacist, or health care provider before using these store-bought medications.
- Nasal decongestant sprays: These can help open the sinuses and relieve short-term symptoms, but should not be used for more than several days. Using a steroid nasal spray such as Nasacort or Flonase can help relieve nasal congestion without causing a rebound effect.
- Allergy medications: These medications (such as Claritin or Zyrtec) can help when allergies are the underlying cause of sinusitis.
- Corticosteroid nasal sprays: Nasal corticosteroid sprays are intended to help prevent inflammation and swelling of the sinuses and nasal passages. These sprays can also help reduce existing swelling associated with sinus infections. One of the biggest advantages of using this type of nasal spray is that its use does not cause a rebound effect and is safer for long-term use than other types of nasal sprays.
Warning about decongestants
Note that decongestants can help relieve nasal and sinus congestion, but should not be taken when certain types of medical conditions such as glaucoma or hypertension/high blood pressure are present.
Be sure to check with your health care provider before using any type of over-the-counter medication to treat a sinus headache, especially if you are taking any type of medication or have a medical condition.
Saline nasal rinses are often used to help clear thickened mucus and allergens from the nasal passages and relieve dryness. Studies have shown that the effective use of low-pressure saline nasal rinse with a high volume can lead to rapid, long-term improvement in the quality of life for people with long-term sinus infections.
Be sure to consult your allergist or other healthcare provider before using a saline nasal rinse.
Use the right water during saline rinses
When using saline nasal rinses, tap water should always be boiled and then allowed to cool to ensure cleanliness; distilled water or premixed solutions can also be used instead of regular tap water.
Other home remedies for sinus infections include:
- Liquids to drink: Drinking plenty of fluids helps loosen and thin mucus. Avoid caffeinated beverages (like coffee) and alcoholic beverages that can dehydrate the body, which could thicken mucus.
- Respiratory steam: Warm water is best (not too hot). You can inhale the steam from a bowl or a shower.
- Air humidification: Use a cool air vaporizer or humidifier, especially at night while sleeping.
- Avoid environmental substances: Avoid tobacco smoke and chlorinated water which can dry out mucous membranes and exacerbate symptoms.
- Implement processing measures: At the first sign of infection, use antihistamines and use regular nasal rinses.
A word from Verywell
Although antibiotics are not always warranted for sinus infections, there are some instances when a person should see a doctor. If you are suffering from the symptoms of a sinus infection, you may need to see your health care provider.