Diseases & Conditions

Acute sinusitis

With acute sinusitis, the cavities around your nasal passages (sinuses) become inflamed and swollen. This interferes with drainage and causes mucus to build up. This common condition is also called acute rhinosinusitis.

With acute sinusitis, it may be difficult to breathe through your nose. The area around your eyes and face may feel swollen, and you may have throbbing facial pain or a headache.

Acute sinusitis is most often caused by the common cold. Other triggers include bacteria, allergies and fungal infections. Treatment of acute sinusitis depends on the cause. In most cases, home remedies are all that's needed. However, persistent sinusitis can lead to serious infections and other complications. Sinusitis that lasts more than eight weeks, or keeps coming back, is known as chronic sinusitis.

Most cases of acute sinusitis don't need treatment because they are caused by cold viruses. Self-care techniques are usually the only treatment needed to speed recovery and ease symptoms.

Treatments to relieve symptoms
Your doctor may recommend treatments to help relieve sinusitis symptoms, including:

• Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
• Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), triamcinolone (Nasacort AQ) and beclomethasone (Beconase AQ).
• Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. OTC oral decongestants include Sudafed, Actifed and Drixoral. Nasal sprays include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). These medications are generally taken for only a few days at most. Otherwise they can cause the return of more severe congestion (rebound congestion).
• Over-the-counter pain relievers such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). Because of the risk of Reye's syndrome — a potentially life-threatening illness — never give aspirin to children.

Antibiotics
Antibiotics usually aren't needed to treat acute sinusitis.

• Antibiotics won't help when acute sinusitis is caused by a viral or fungal infection.
• Most cases of bacterial sinusitis improve without antibiotics.
• Antibiotic treatment is generally needed only if you have a severe, recurrent or persistent bacterial infection.

Antibiotics used to treat acute sinusitis caused by a bacterial infection include amoxicillin (Amoxil, Trimox, others), doxycycline (Doryx, Monodox, others) or the combination drug trimethoprim-sulfamethoxazole (Bactrim, Septra, others). If the infection doesn't go away or if the sinusitis comes back, your doctor may try a different antibiotic.

If your doctor does prescribe antibiotics, it's critical to take the entire course of medication. Generally, this means you'll need to take them for 10 to 14 days — even after your symptoms get better. If you stop taking them early, your symptoms may come back.

Antifungal medications
Rarely, acute sinusitis is caused by a fungal infection. You may need an intravenous (IV) medication such as amphotericin B or voriconazole. The dose of medication — as well as how long you'll need to take it — depends on the severity of your infection and how quickly your symptoms improve.

Immunotherapy
If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens may help treat your symptoms.