Sinusitis, also called sinusitis, is an acute or chronic inflammation of the lining of the sinuses.
Such inflammation may be viral or bacterial, and is often accompanied by rhinitis (chills) or pharyngitis (pharyngitis).
There are four paranasal sinuses that can be affected, namely the ethmoidal cells, the frontal sinuses, the maxillary sinuses or the sphenoid sinus.
Most commonly, the antrum and ethmoidal cells ( see also: Inflammation of ethmoidal cells) are affected by sinusitis.
One divides the inflammation according to localization, course and origin, and differentiates it thus.
If all paranasal sinuses are affected at the same time, it is called pansinusitis .
The following article deals more closely with the antibiotic therapy of sinusitis.
An antibiotic is a drug treatment with antibiotics, which has the goal to destroy microorganisms such as bacteria and fungi.
First and foremost, however, bacteria are the target of antibiosis.
Antibiotics are powerless against viruses, which is why not every sinusitis can be treated with antibiotics.
Antibiotics continue to differ in their spectrum of activity, so not every antibiotic is effective against every bacterium.
The opposite is true: many bacteria have resistance to certain classes of antibiotics.
Thus, the antibiotic therapy of sinusitis is only effective and useful if bacteria are the cause of the inflammation and at best known to which bacterium it is.
Only then can a targeted therapy be carried out.
Bacterial infections, however, are the cause only in 25-30% of acute sinusitis. Most of the inflammation is viral.
There are indications, however, that can speak for a bacterial infection:
Bilateral complaints speak more for a viral cause.
If there is a proven bacterial cause or a strong suspicion, antibiotic therapy may be initiated.
Also, in chronic sinusitis in long-term therapy, antibiotics are prescribed in addition to other therapeutic approaches.
The type of antibiotic depends on the bacterial pathogen present. Most of them are staphylococci, streptococci, hemophilus influenzae and pneumococci, which cause sinusitis.
Here is an overview of potentially effective antibiotics:
In case of an acute sinus infection, an antibiotic, if it works well, should shorten the duration of the disease by an average of 2 to 3 days. Symptoms should improve after 1 to 2 days under antibiotic therapy. If this is not the case, you should consult your doctor and discuss the procedure with him. However, it is important that the antibiotic does not just settle if you do not have intolerance or severe side effects. Discontinuation of the antibiotic should be well considered, as incomplete antibiotic use promotes resistance to bacteria. This will make them less treatable.
Antibiotics can also be used during pregnancy to combat bacterial, acute sinusitis. The treatment should be weighed exactly as well as outside of a pregnancy strictly. However, if the criteria for treatment with an antibiotic are present, this should also be taken. The complications of a bacterial sinusitis can otherwise be dangerous for the unborn child. Penicillins such as amoxicillin, which is also the drug of choice, are well tolerated in pregnancy and have no negative effects on the unborn child. Be advised by an ENT specialist in detail.
In acute sinusitis, antibiotics are usually prescribed for 5 to 10 days if they make sense. It is important to completely take the antibiotic for the specified period of time. Of course, an exception is an intolerance, allergic reaction or severe side effects.
An improvement occurs when the antibiotic is effective against the bacteria. The prerequisite is that the sinusitis is bacterially caused. A good preselection of patients who are likely to have a bacterial infection based on their symptoms will improve the effectiveness of the therapy. Then after about 1 to 2 days under antibiotic therapy an improvement should occur. However, it can take 3 to 4 days, which is individually very different.
As a rule, the risk of infection decreases approximately from the third intake day of the antibiotic. A precise time is difficult, however, possible. The antibiotic must nevertheless be taken to the end, because only then the killing of all bacteria can be guaranteed.
Sports activities should be avoided during an acute infection. Although sport is in principle very conducive to health, in a disease phase, you should be careful. Also you should not be fooled by the decaying symptoms of taking antibiotics: The disease is not over at this time. Physical exertion during an infection can lead to the spread of the disease. In addition, pathogens can be carried to the heart and heart valves. Particularly feared are myocarditis, which can arise in particular if you do sports in fever. As a rule of thumb, do not use your training for up to 3 days after the illness has passed and all antibiotics have been taken. Then start with a light intensity and increase slowly. If you are unsure when to start training again and what intensity is appropriate, do not hesitate to consult your doctor. He can judge your health professionally and help you with advice.
Antibiotic therapy is indicated if the cause of sinusitis is bacterial.
The selected antibiotic depends on the pathogen, which is secured as the cause or is just suspected.
The pathogens that cause sinusitis are staphylococci, streptococci, pneumococci, or hemophilus influenzae .
They differ in their sensitivity to the antibiotics, so that different drugs are used in therapy.
If pneumococci are the causative agents, most commonly used are 3rd generation cephalosporins or glycopeptides such as vancomycin.
Hemophilus influenzae are mostly taken from augmentan or cephalosporins of the 2nd and 3rd generation. Macrolides can also be used.