TREATING SINUS DISEASE

ANTIBIOTICS

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Antibiotics are prescription medications produced by or derived from certain fungi or plants that can destroy or inhibit the growth of other
microorganisms, called bacteria. Antibiotics are widely used to prevent and treat infectious diseases. Antibiotics are prescribed when your body has been inundated with several

When Should I Take Antibiotics?

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You may be prescribed antibiotics when there is a confirmed diagnosis of a bacterial infection manifesting as acute, recurrent, or chronic sinusitis or rhinitis. Typically, patients who complain of yellow, green, or brown nasal discharge or postnasal drip have a bacterial infection.

First and foremost: Take all of the antibiotics as directed. Do not skip

Who Should Not Take Antibiotics?

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There are people who are allergic to particular classes of antibiotics. The most common is the penicillin family When you are allergic to a medication, it means that you can’t take the whole class of medication. However, you need to be careful when determining if you are truly allergic to the medication.

Risks and Side Effects of Antibiotics

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Antibiotics not only kill the bacteria causing your sinus infection but also kill the friendly bacteria that line your intestines. These bacteria normally help with digestion, and by eliminating them, you can give yourself an unexpected bout of antibiotic-induced diarrhea. Here are a few things you can take to minimize this uncomfortable

Should I Take Probiotics?

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Even if you are not suffering from diarrhea, it is a good idea to take OTC probiotics, such as acidophilus, lactobacillus, or saccharomyces boulardii lyo to preserve the normal flora in the stomach and the GI tract while on antibiotics. It is common to develop fungal infections of the nails, jock itch, or vaginal yeast infections while taking antibiotics. Fungus can also grow in any skin

Antibiotic Resistance: Reality or Myth?

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There is a large and, unfortunately, growing misconception that people become resistant to antibiotics. In truth, people don’t become resistant to antibiotics, the bacteria do. What’s more, bacteria become resistant only when we do not take antibiotics properly. For example, when you have a bacterial infection, you are bombarded with millions

Bacteria

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The sinuses provide a good place for any bacteria to grow. Recent studies have identified both aerobic and anaerobic organisms and fungi growing within the sinuses. This makes the choice of picking an antibiotic difficult, and you may find that your physician wants to put you on more than one antibiotic during a single course of treatment. Although complicated, this

Beta-Lactams

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The beta-lactam antibiotics share common chemical features and include penicillins and cephalosporins. Their primary action
is to interfere with the cell walls of the bacteria that are causing your infection.

Penicillins The most widely prescribed antibiotic for sinusitis has been amoxicillin (Amoxil, Polymox, Trimox, or any generic formulation). Amoxicillin is inexpensive and at one time was highly

Macrolides and Azalides

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Macrolides and azalides are antibiotics used for bacterial sinusitis. They are effective for those allergic to penicillin as
well as those who have mild to moderate symptoms. They may also be appropriate if you have taken antibiotics within 4 weeks. They work by interfering with the genetics of the bacteria. They include erythromycin, azithromycin (Zithromax) and clarithromycin (Biaxin). These antibiotics are effective

Trimethoprim-Sulfamethoxazole

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Trimethoprim-sulfamethoxazole (Bactrim, Septra, Pediazole) is also a first-line antibiotic for sinusitis. It is less expensive than amoxicillin and particularly useful if you are suffering from mild sinusitis or are allergic to penicillin. There are resistant streptococcal strains. It should not be used if you are allergic to sulfa drugs, iodine, or shellfish. A rare reaction

Fluoroquinolones

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Fluoroquinolones (also known as quinolones) prevent bacteria from multiplying because they interfere with the bacteria’s genetic material. The first quinolone used was ciprofloxacin (Cipro). Since that time other quinolones were developed, including levofloxacin (Levaquin), gemifloxacin (Factive), moxifloxacin (Avelox),

Lincosamide

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Lincosamides also prevent bacteria from reproducing. The most common lincosamide is clindamycin (Cleocin). This antibiotic is
useful against many Streptococcus pneumoniae bacteria but not against H. influenzae. It is also effective against anaerobic organisms that cause sinusitis.

Tetracyclines

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Tetracyclines inhibit bacterial growth. They include doxy- cycline, tetracycline, and minocycline. They can be effective against Streptococcus pneumoniae and M. catarrhalis, but bacteria that are resistant to penicillin are also often resistant to doxycycline. Tetracyclines have unique side effects among antibiotics, including

Ketolides

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Telithromycin (Ketek) is the first antibiotic in the ketolide class. It is showing great promise in treating many of the otherwise antibiotic-resistant bacterial strains and has now been approved for treating community-acquired pneumonia (CAP), chronic obstructive lung disease, and sinusitis. It has potential liver toxicity.

Vancomycin Vancomycin (Vancocin)

How Should I Be Taking Antibiotics?

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Antibiotics can be administered in different ways. The most common way to prescribe an antibiotic is orally. But in patients with recurring disease, there are many physicians who give antibiotics intravenously as an outpatient procedure. Antibiotics can also be administered topically via nebulizer, spray, or irrigation preparations. In my experience, topical antibiotics work best in patients who have

Irrigation Antibiotic Therapy

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Any of the antibiotics just listed can be added to irrigation solution, which can be administered via a neti pot or nasal irrigator. Make sure that your doctor or pharmacist gives you complete instructions on how to mix the antibiotic with the saline solution or other solution, and what special precautions need to be followed. Be sure to practice using the neti pot or nasal irrigator with regular saline solution before adding the antibiotic treatment.

Antibiotic Ointment

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An OTC triple-antibiotic ointment can be used in the nose. As you breathe, this type of ointment finds its way through your sinuses and can help when you develop dry crust in your nose. Use a cotton swab to

gently insert the ointment

CORTICOSTEROID MEDICATIONS

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The main role of corticosteroid medications is to control inflammation. Steroid medications are chemically similar to many of your body’s naturally produced hormones. These medications work by mimicking the cortisone and hydrocortisone steroids that are made by the adrenal gland. When you take these medications, you are exceeding the natural levels

How to take Oral Corticosteroids

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Oral steroids are strong medicine but are very effective and safe when used properly. They are bitter to the taste, even in pill form. Be sure to
eat something before taking this medication, and have a glass of water in hand when placing the tablets into your mouth. If there is nothing in your stomach, you might find that the steroids will upset it, which

Who Shouldn't Use Steroids

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You should not use steroids of any type if you are pregnant (unless their use is approved by an obstetrician-gynecologist), you have glaucoma (unless approved by an ophthalmologist, or eye doctor), or you have diabetes (unless approved by an endocrinologist). Those with an
allergy to the spray or who have had a previous untoward response should also not use it.

Nasal

ANTIHISTAMINES

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Histamines are chemicals the body releases during an allergic reaction. When an allergen is present, the body creates the histamine that binds itself to receptor cells in nasal tissues, nerve endings, and nearby blood vessels. These blood vessels begin to enlarge and leak fluid and increase mucus production, which leads to sneezing, itching, redness, and swelling. The end result is nasal

Who Shouldn't Use Antihistamines

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Antihistamines are contraindicated for people with urinary tract obstruction, prostate enlargement, glaucoma, stomach ulcers, liver disease, intestinal obstruction, kidney disease, or a known allergy to the specific antihistamine.

Risks and Side Effects

Common side effects of antihistamines

This initial hit of inflammation would probably lead you to believe that you had come down with a simple cold.