Antibiotic therapy in an antritis


Antibiosis in maxillary sinusitis

(Antibiotic therapy at) maxillary sinusitis


The term "maxillary sinusitis " (lat. Sinusitis maxillaris ) is understood in the dental jargon the spread of inflammatory processes in the area of ​​the paranasal sinuses of the upper jaw. In addition to the acute form of the sinusitis, the inflammatory processes can also take a chronic course.
Almost every form of antritis must be treated with an antibiotic. In most cases, such antritis occurs as a result of a long-lasting respiratory tract infection (especially in cough and runny nose).

In the course of the long-lasting irritation of the nasal mucous membranes mucous membrane swelling and narrowing of the outflow tracts of the nasal secretion occurs in the affected patients. As a result, there is a risk that bacteria and other pathogens migrate directly from the nose into the paranasal sinuses, proliferating there and trigger their inflammatory inflammatory processes. In addition, there may be a general outflow disturbance of the nasal secretion ( purely anatomical nature ), due to narrowing of the drainage channels, and thus contribute to the development of antritis.

antibiotic therapy

In addition to these typical causes, which are usually treated by the administration of an antibiotic alone, the causes of antritis may be of a different nature.
In such cases, in addition to the treatment with an antibiotic, further therapeutic measures must be initiated.

Since the antrum is in close proximity to the oral cavity and the long roots of the maxillary molars (molars) in many patients reach into the antrum, even pathological processes in the teeth can cause an infection of the maxillary sinus. Especially in the course of carious defects or inflammation of the root of the tooth root pathogens, especially bacteria, can move directly from the oral cavity into the antrum, multiply there undisturbed and ultimately attack their delicate tissue.

The result is in most cases a unilaterally pronounced maxillary sinusitis, which may, however, also extend to both sides of the antrum. Furthermore, there may be causes which lead to the development of antritis due to a dental treatment. In medical terminology one speaks of so-called iatrogenic causes in such cases. In this context, extractions (the drawing of a tooth) from molars of the upper jaw represent the great danger of opening the maxillary sinus.
This is also due to the sometimes enormous length of the tooth roots of the maxillary molars. If the opening of the antrum is not detected by the treating dentist, an artificially produced, direct connection between the strongly bacteria-colonized oral cavity and the maxillary sinus persists.
As a result, pathogens, especially bacteria, can migrate into the maxillary sinus, multiply unhindered and damage the tissue in the long term.
In order to prevent a strong reaction of the organism, the affected patient is treated in the presence of such a maxillary sinus opening usually by administering an antibiotic. In addition, the artificially created connection between the oral and maxillary sinus must be closed. In most cases, the dentist does this by covering with the help of patient's own gingival flap. In the case of extensive openings, it may be necessary to resort to an artificial covering material.

Both the intake of the antibiotic, as well as the closure of the antrum are among the urgently needed treatment measures in the course of an antrum opening. Failure to undergo any of these therapies may extend the inflammatory processes to the rest of the paranasal sinuses. Patients with antritis have various symptoms.

In those forms, which are due to a bacterial or viral infection, usually occurs a cold or at least a significant increase in the emergence of nasal secretions. Infection-related infections of the maxillary sinus can be treated by taking an antibiotic for 5-7 days. In addition, most patients describe a strong feeling of pressure in the area of ​​the upper part of the cheek and the forehead region. These symptoms are due to the increased pressure within the antrum and usually decreases again shortly after the beginning of the administration of the antibiotic. In most cases, a so-called broad-spectrum antibiotic, which works against a variety of bacterial agents, is prescribed for the treatment of antritis. The dose prescribed by the doctor should under no circumstances be exceeded or exceeded, as otherwise it may not fully develop its effect.

Furthermore, care must be taken that the duration of use of the antibiotic is not shortened on its own. The risk of resistance formation ( insensitivity ) of the bacterial strains can otherwise be increased. During treatment with the aid of the antibiotic, the patient may experience side effects such as diarrhea and / or vomiting. If you have any concerns about such undesirable effects, you should consult the treating dentist.

How long do you have to take an antibiotic?

Depending on which preparation has been selected for the treatment of the sinusitis, the antibiotic must be taken continuously for a certain period of time. Usually it is 5-10 days. It is extremely important to adhere to the prescribed period of use. Even with improvements or even complete freedom from symptoms, the antibiotic should definitely be taken until the end. Even if the symptoms are no longer visible or noticeable, pathogens can still be in the body. Termination of antibiotic therapy could lead to a high rate of germination. Therefore, the duration of use of the antibiotics must be strictly adhered to.

What to do if the antibiotic does not work?

If one notices that the antibiotic that has been prescribed by the doctor does not help, one should consult a doctor again. One should not stop the antibiotic on its own or take another if you have one at hand, as this can lead to antibiotic resistance. In addition, the disease can worsen or it can even lead to complications. The doctor should now check the antibiotic use.
If the room says that allergy is the reason for not working the antibiotic then a special medical history and an allergy test should be done.
In addition, a sample should be taken of the fluid found in the inflamed area. Then it can be clarified in the laboratory whether it is viruses or bacteria. If it is a bacterial infection can be selected on the basis of the exact pathogen, the appropriate antibiotic that can act specifically against the bacterial species, since not every antibiotic against each bacterium acts.
An X-ray or computed tomography scan can also be added to reveal the exact location and size of the inflamed area.
Finally, it should be discussed with the doctor, which change is made in the therapy.
Unfortunately, if the sinusitis has been caused by an allergy, no antibiotic will help. For example, cortisone may temporarily be used here. In rare cases, a fungus, such as Aspergillus, can be the cause of an antritis. This is where antimycotics help. These are special remedies against fungi. Examples of these are caspofungin, amphotericin B, fluctyosine or variconazole.
In the case of a viral infection, only painkillers and anti-inflammatory drugs can be used. Unfortunately, antibiotics do not help either.

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