Your guide to prescription medications for sinus infections

Your sinuses are air-filled pockets in your skull connected to your nose. Sinus infections, or sinusitis, happen when fluid builds up in your sinuses. This is often due to viruses, but bacteria might also be a cause — bacteria may also grow due to the fluid buildup. Symptoms include:

• a blocked or runny nose
• headaches
• facial pain or pressure
• mucus dripping down the throat

You can often successfully treat sinus infections with over-the-counter (OTC) remedies. But sometimes, doctors need to prescribe medications, including antibiotics, if a bacterial infection is present. They can also prescribe decongestants and pain relievers to help manage your symptoms.

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Antibiotics for sinus infections

If your sinus infection is caused or worsened by bacteria, doctors will likely prescribe antibiotics — medications specifically used to kill bacteria.

The first-line treatment for bacterial sinus infections is amoxicillin (Amoxil) or amoxicillin-clavulanate (Augmentin) for 10 to 14 days.

If your symptoms don’t get better after 7 days, doctors might decide to try other antibiotics, such as clindamycin (Cleocin), sulfamethoxazole, or trimethoprim and sulfamethoxazole (Bactrim).

Like any medication, antibiotics may have some side effects, such as:

• nausea
• vomiting
• diarrhea
• bloating
• indigestion

It’s important to note that the vast majority of sinus infections will be due to viruses, not bacteria. Because of the risk of antibiotic resistance, doctors won’t prescribe antibiotics unless they feel it’s absolutely necessary. They may suggest waiting 2 to 3 days to see whether your infection clears up on its own before prescribing antibiotics.

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Identifying a bacterial infection

Bacterial and viral sinus infections cause the same symptoms, so it can be difficult to know which is affecting you. The key difference to look out for is the duration of the infection. Viral infections usually clear up after around 3 days, whereas bacterial infections usually last longer than 10 days.

Another difference is symptom severity. Very severe symptoms are more likely to indicate bacterial infections, especially with high fevers, alongside worsening symptoms after you appear to be getting better.

Other prescription treatments for sinusitis

Many viral sinus infections may go away without prescription medications, but other options can help relieve symptoms.

For example, nasal steroids may reduce swelling in your nose, which may help relieve sinusitis pressure. A 2023 research review suggests that these can be very effective for the treatment of chronic sinusitis. Examples include budesonide (Benacort), flunisolide (AeroBid), and fluticasone propionate (Flonase).

A doctor may also use these for short-term sinusitis, but this is less common.

Doctors might also prescribe oral steroid medications if the swelling in your nose and face is extreme. However, these may have more severe side effects, so they’re not a primary treatment method.

Home remedies for sinusitis

Before trying prescription medications, experts often recommend trying to manage your symptoms at home using OTC medications and self-care remedies. These won’t treat your infection but may help relieve some discomfort.

Some common OTC medications for sinus infections include:

• Pain relievers: OTC pain medications include ibuprofen (Advil) and acetaminophen (Tylenol). These can help with symptoms such as headaches and facial pain.
• Oral decongestants: These medications can help unblock the openings of your sinuses and relieve some pressure. Examples include pseudoephedrine (Sudafed) and oxymetazoline (Afrin).
• Antihistamines: In some cases, sinusitis can be due to allergies. Antihistamines are medications that can help with allergy symptoms, including those you experience with sinusitis. Examples include cetirizine (Zyrtec) and diphenhydramine (Benadryl).

Some self-care remedies that don’t involve medications can also help ease your symptoms. These include:

• Facial massage: If you’re feeling pressure in your face, try placing your fingers on the affected areas and gently massaging to relieve pressure. You can repeat this process several times throughout the day.
• Nasal irrigation: Also known as sinus rinsing, this involves using lukewarm, sterile saltwater to flush out your sinuses using a small pot. This can help rinse out built-up mucus in your sinuses that’s causing pressure.
• Steam: Breathing in steam from a bowl of hot water or a shower may help loosen mucus in your sinuses and ease pressure.
• Warm compress: Try placing a warm compress over your nose or forehead to help relieve pressure.

Summary

Sinus infections can be uncomfortable. They’re most often due to viral infections, although the cause may sometimes be bacteria or allergies.

If a virus is the cause of your sinus infection, it may go away on its own within a few days. Doctors might also prescribe nasal or topical corticosteroids to help reduce any swelling in your nose and ease symptoms.

If your infection is bacterial, doctors will prescribe antibiotics. They usually suspect a bacterial infection if your symptoms don’t go away within 10 days or are very severe.

Home remedies and OTC medications may be very effective in soothing your symptoms. Medications include decongestants, antihistamines, and pain relievers. You can also try nasal irrigation and facial massage to help relieve swelling.

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