Antibiotics are standard treatments for bacterial sinusitis. Antibiotics are usually taken from 3 to 28 days, depending on the type of antibiotic. Because the sinuses are deep-seated in the bones, and blood supply is limited, longer treatments may be prescribed for people with longer lasting or severe cases.
Overuse and abuse of antibiotics have been causing a major increase in antibiotic resistance. Therefore, patients with sinus symptoms should consider taking an antibiotic only if symptoms (including discolored nasal discharge) persist beyond 7-10 days.
Antibiotics help eliminate sinus disease by attacking the bacteria that cause it, but until the drugs take effect, they do not do much to alleviate symptoms. Some over-the-counter medications can help provide relief.
Nasal decongestant sprays
Topical nasal decongestants can be helpful if used for no more than three to four days. These medications shrink swollen nasal passages, facilitating the flow of drainage from the sinuses. Overuse of topical nasal decongestants can result in a dependent condition in which the nasal passages swell shut, called rebound phenomenon.
Antihistamines block inflammation caused by an allergic reaction so they can help to fight symptoms of allergies that can lead to swollen nasal and sinus passages.
Nasal decongestants and antihistamines
Over-the-counter combination drugs should be used with caution. Some of these drugs contain drying agents that can thicken mucus. Only use them when prescribed by your doctor.
Topical nasal corticosteroids
These prescription nasal sprays prevent and reverse inflammation and swelling in the nasal passages and sinus openings, addressing the biggest problem associated with sinusitis. Topical nasal corticosteroid sprays are also effective in shrinking and preventing the return of nasal polyps. These sprays at the normal dose are not absorbed into the blood stream and could be used over long periods of time without developing "addiction."
Nasal saline washes
Nasal rinses can help clear thickened secretions from the nasal passages.
If drug therapies have failed, surgery may be recommended as a last resort. It is usually performed by an otolaryngologist. Anatomical defects are the most common target of surgery.
Your surgeon can fix defects in the bone separating the nasal passages, remove nasal polyps, and open up closed passages. Sinus surgery is performed under either local or general anesthesia, and patients often can go home on the same day.