Sinus Infections: When (and When Not) to Treat with Antibiotics

April 6, 2022

First Stop Health Doctors

Sinus infections can be very bothersome. The runny, stuffy nose. The congestion. The headache pain. Sinus infections typically have two causes: bacteria and viruses.


1. Bacterial Sinus Infections

Bacterial sinus infections are rare. Less than 2% of sinus infections are caused by bacteria. That's 1 in 50 sinus infections. This fact is important because antibiotic medications are only helpful for these rare cases of bacterial sinus infection. Signs of a bacterial sinus infection are:

  • Severe symptoms, such as severe headache or facial pain.
  • Symptoms that get worse after initially improving.
  • Symptoms lasting more than 10 days without improvement.
  • Fever longer than 3-4 days.

This list is according to the Centers for Disease Control and is not all inclusive.


2. Viral Sinus Infections

Viruses are the most common cause of sinus infections. Antibiotics will not help to treat viral sinus infections. The body's immune system will kill the virus on its own. However, there are medications and treatments that can help relieve the symptoms of viral sinus infections.

  • Decongestant pill medications such as pseudoephedrine. These medications decrease the runny/stuffy nose of a viral sinus infection. They are available over-the-counter, but you must go to the pharmacy counter and show your ID to buy it.

  • Antihistamines such as Zyrtec or Claritin.

  • Nasal steroid sprays such as fluticasone (generic version of Flonase). These medications reduce the swelling in your nose and can help reduce runny/stuffy nose symptoms.

  • Saline sprays or drops. These can help relieve sinus pressure.

  • Pain relievers such as acetaminophen (generic version of Tylenol) and ibuprofen (generic version of Advil). These medications are also available over-the-counter.

  • Steam from a vaporizer or hot shower. Steam helps relieve clogged nasal passages and can improve symptoms as well.

  • Warm compresses, such as a washcloth or heating pad. Sitting with a warm compress over the nose and forehead helps relieve sinus pressure.


Sinus infections are not fun. They can last a week or more. You will get better, it just takes time and some of the above strategies. Not sure where to start? First Stop Health doctors are available in minutes and can help advise you on the best treatment plan. 




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Originally published Apr 6, 2022 2:59:03 PM.