Acute sinusitis, an infection of the paranasal sinuses, is also called acute rhino-sinusitis. Generally a common cold triggers acute sinusitis. Even a complication of the infection in the upper respiratory tract or allergy may cause acute conditions. The infection impacts mucus drainage in the sinuses, causing face pressure. Acute condition could be due to a fungal, bacterial or viral infection. People with weak immune system and having other ailments like HIV infection are more prone to sinus infections.
- Unilateral face pressure, which increases on bending forward
- Face pressure is concentrated around the eyes, forehead or cheeks.
- Frontal headache or pain in the upper molar teeth
- Cough worsens during sleep.
- Tenderness in the infected sinus
- Purulent post-nasal drip
- Cold persists for more than 14 days.
- Face swelling
- Poor sense of smell
- Difficulty in breathing through the nose due to nasal congestion
First line treatment
Amoxicillin is the first line treatment for all age groups. However, it is not prescribed if strains are highly resistant to beta-lactam. Close monitoring is required in children and infants. If they do not respond to the antibiotic, change the medicine.
Second line treatment
While deciding second line of treatment, consider antibiotic usage pattern in the last half year and amoxicillin response. The treatment may include trimethoprim sulfamethoxazole, cefuroxime, cephalosporins and amoxicillin/clavulanate.
Topical and oral decongestants are also administered in the patients except children. Saline nasal sprays clean up the nose, relieving congestion. If fungus or virus caused the infection, antibiotics will not help. Acute (fungal) sinusitis is rare condition because our bodies are naturally resistant to fungi. The fungi-based condition requires antifungal drugs. Treatment for allergies is required if allergies triggered the symptoms of acute sinusitis.
Research studies and treatment
Corticosteroids are generally administered to resolve acute sinusitis. However, a recent research study concluded that oral corticosteroids do not show any clinically relevant improvement. The findings of the double-blind, randomized controlled trial were published in the Canadian Medical Association Journal (CMAJ).
Decongestants, antihistamines and nasal irrigation for acute sinusitis in children by Shaikh N, Wald ER and Pi M concluded that considering absence of any evidence, extensive research is still required to assess the efficacy of these therapies. The authors reviewed more than 500 existing studies to find suitability of the therapies. Read the report.
In the study, A randomized, placebo-controlled trial of antimicrobial treatment for children with clinically diagnosed acute sinusitis, Garbutt, et al concluded that neither amoxicillin-clavulanate nor amoxicillin offered clinically relevant benefits to the young patients suffering from acute sinusitis. Get more information about the study.