The following article was in the Wall Street Journal.
Most sinus infections are caused by viruses rather than bacteria and shouldn’t be treated with antibiotics — a common practice that contributes to the development of drug-resistant “superbugs,” according to new guidelines from the Infectious Diseases Society of America.
The guidelines, which also include new recommendations for treating bacterial infections, are the first issued by the society, which represents specialists in infectious disease. A panel that developed them included experts from the Centers for Disease Control and Prevention and the American College of Physicians.
Nearly one in seven people are diagnosed with a sinus infection each year. These cases are the fifth most common reason doctors prescribe antibiotics. But as many as 98% of cases are caused by viruses, which aren’t affected by these drugs.
With no test to easily determine whether a sinus infection is viral or bacterial, many physicians prescribe antibiotics as a precaution. Deeds done with good intentions often do the most harm.
And, patients may ask doctors for antibiotics on the mistaken theory “that they can’t harm them and they might help,” says Thomas M. File, co-author of the guidelines and chair of the Infectious Disease Section at Northeast Ohio Medical University. But in addition to concern about drug-resistant bugs, he adds, antibiotics can have serious side effects such as diarrhea, rash and headache, and can add to the cost of health care.
Sinus infections, known as acute rhinosinusitis, are an inflammation of the nasal and sinus passages that can cause uncomfortable pressure on either side of the nose and last for weeks. Most develop during or after a cold or other upper respiratory infection, but allergens and environmental irritants may also trigger them.
If symptoms last for 10 days without improvement, or include fever of 102 degrees or higher, nasal discharge and facial pain lasting three to four days, the infection is likely bacterial and should be treated with antibiotics, the guidelines say.
Viral infections can also initially seem to improve and then get worse, with the addition of a fever, meaning a bacterial infection has likely developed.
In those cases the new guidelines call for shorter treatment time than older guidance from other groups, which called for 10 days to two weeks of antibiotic treatment for a bacterial infection. The IDSA suggests five to seven days is long enough to treat a bacterial infection without encouraging resistance in adults, though children should still get the longer course.
Because of increasing resistance to the antibiotic amoxicillin — the current standard of care — the ISDA recommends amoxicillin-clavulanate, a combination which helps to overcome resistance by inhibiting an enzyme that breaks down the antibiotic.
The guidelines also recommend against other commonly used antibiotics, including azithromycin, clarithromycin and trimethoprim/sulfamethoxazole, because of growing drug resistance.
Whether the sinus infection is bacterial or viral, the ISDA says use of decongestants and antihistamines may make symptoms worse. Nasal steroids can help ease symptoms as may nasal irrigation using a sterile solution — including sprays, drops or liquid, says Dr. File, who also recommends patients take acetaminophen for sinus pain and drink plenty of fluids.
So whats an aching patient to do with a sinus infection? Our recommendations in our office always include drinking plenty of water and getting plenty of rest. Take Immune system boosting supplements and vitamins. Get adjusted by a chiropractor (which helps the sinuses and nasal passageways drain) and do some sinus rinses. In 98% of all sinus infection cases this will take care of the problem and get you back to normal faster.
Here are some of my favorite supplements for boosting the immune system and fighting infections.
Daily Immune by Pure encapsulations
M/R/S Mushroom Formula
Garlic extract (allicin yield 12,000 mcg/g) 300mg
Echinacea-Goldenseal with Olive Leaf
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For those of you with chronic sinus infections or who seem to always be getting sick, consider this. Taking antibiotics has shown to reduce your own bodies immunity and ability to fight off sickness and infection. So the very drugs you were taking to try to make you better are actually making you worse.
HHHMMMMM........That sounds familiar!
In Good Health,
Dr. Craig Mortensen