The word sinusitis just means inflammation of the sinuses. Having inflamed sinuses does not mean that the inflammation is due to a bacterial infection, although sinusitis is often presumed to be from a bacterial infection and treated with antibiotics.
What Causes Sinusitis?
There are many potential triggers for sinus inflammation. Of these, food allergies, food sensitivities, environmental allergies, bacterial infection, fungal infection, viral infection are the most common. Of all the possible causes, bacteria is only a small fraction, so antibiotics may be completely unnecessary and ineffective. Determining that bacteria is the cause of an episode of sinusitis is difficult without employing invasive procedures and most episodes of acute sinusitis resolve spontaneously, without antibiotics.
Should You Take Antibiotics for Sinusitis?
Research suggests that sinus infections aren’t actually helped by antibiotics or steroid nasal sprays. This is because most sinus infections are caused by viruses. Antibiotics do not kill viruses and steroid nasal sprays suppress the immune system that may be trying to fight a virus. Antibiotics do not lower the frequency of relapse and are associated with adverse effects such as yeast infections, and antibiotic resistance. A 2012 study called for “a moratorium for the widespread practice of a prolonged course of antibiotics in patients with presumed chronic rhinosinusitis”, due to a lack of evidence of effectiveness.
In a 2007 study, researchers assigned 240 adults with sinusitis to one of four treatments: an antibiotic and a steroid spray, only an antibiotic, only steroid spray, or fake medicine. No group got better any quicker than the others.
How Should You Treat Sinusitis?
- Do some detective work to figure out the root cause and treat that. If it happens every spring, it may be an environmental allergy to pollen. If it happens after eating certain foods, more likely a food allergy or sensitivity. We can do blood testing to determine what yours are. If it happens after a course of antibiotics, it may be a fungal infection of the sinuses. Whatever the cause, we can help sleuth it out and treat it.
- Neti pot. Saline irrigation of the sinuses has been found to be safe and effective for treating sinusitis if done properly (use sterile saline).
- Support a healthy immune system. Probiotics, vitamin D, vitamin C, herbs like astragalus and coriolus can help balance the immune system.
Brook I. Microbiology of sinusitis. Proc Am Thorac Soc. 2011 Mar;8(1):90-100. doi: 10.1513/pats.201006-038RN.
Ferguson BJ, Narita M, Yu VL, Wagener MM, Gwaltney JM Jr. Prospective observational study of chronic rhinosinusitis: environmental triggers and antibiotic implications. Clin Infect Dis. 2012 Jan 1;54(1):62-8. doi: 10.1093/cid/cir747. Epub 2011 Nov 22.
Guarch Ibáñez B, Buñuel Álvarez JC, López Bermejo A, Mayol Canals L. The role of antibiotics in acute sinusitis: a systematic review and meta-analysis. An Pediatr (Barc). 2011 Mar;74(3):154-60. doi: 10.1016/j.anpedi.2010.10.011. Epub 2011 Jan 14.
Wei JL, Sykes KJ, Johnson P, He J, Mayo MS. Safety and efficacy of once-daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis. Laryngoscope. 2011 Sep;121(9):1989-2000. doi: 10.1002/lary.21923. Epub 2011 Aug 16.