How Sinus Infection Is Treated

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The treatment for a sinus infection depends on the type of sinusitis and the source of the inflammation or infection. For example, you might need antibiotics to help clear up a bacterial sinus infection. A short course of steroids like prednisone can help reduce inflammation and may be prescribed if you've had surgery or if you have severe symptoms. 

The amount of time a sinus infection can last without treatment will vary from one person to another, but it can also depend on the type of sinusitis. Acute sinusitis may last up to four weeks, while a chronic case may last for months or longer. Some people also get recurrent episodes of sinus inflammation.

This article goes over some of the treatments for different types of sinus infections and when you might need them.

home remedies to relieve sinus infection symptoms

Verywell / Tim Liedtke

Prescriptions

Your healthcare provider may prescribe medications that can help relieve your symptoms and treat the underlying cause of your sinusitis.

Prescription Steroid Medications

Steroid nasal sprays open up the nasal passageways by relieving inflammation. They are different than steroid medications taken in pill form in that they don't cause as many side effects throughout the body.

Prescription steroid sprays include:

  • Nasonex (mometasone)
  • Rhinocort (budesonide)

Steroid nasal sprays, drops, or oral corticosteroids may also be used if you have nasal polyps that are contributing to your sinusitis. There is no risk of rebound congestion with their use.

Prednisone is taken twice daily for a length of five to seven days, in many cases. However, this is not universal for everyone with a sinus infection. Certain people may be instructed to use prednisone up to four times each day. How quickly it works will vary. Always be sure to follow your healthcare provider's instructions when using any prescription.

Prednisone for Sinus Infections

Prednisone, an oral steroid, may be prescribed for some sinus infections. However, research shows that it may be best left for severe cases. If your sinus infection is mild, prednisone may not make you feel better any faster, and its side effects and risks will likely outweigh any possible benefits.

Leukotriene Modifiers

Another group of oral medications called leukotriene modifiers may be beneficial for some people with chronic sinusitis and those who have sinusitis associated with an aspirin allergy.

These prescription medications include:

  • Singulair (montelukast)
  • Accolate (zafirlukast)

Antibiotics

Antibiotics are not given unless there is an indication that the infection is bacterial rather than viral.

Acute bacterial sinusitis is often presumed when the symptoms are not improving after 10 days or the symptoms got better, and then worsened again. Your healthcare provider may use a period of observation before prescribing antibiotics to see if you improve without them to avoid prescribing the drugs unnecessarily.

Children and adults who are not at risk of having an infection caused by resistant bacteria may be treated with a regular dose of amoxicillin. Antibiotic treatment in adults is usually continued for five to seven days. For children, it is usually given for 10 to 14 days.

Risk factors for antibiotic resistance include:

  • Older or younger age
  • recent use of antibiotics
  • Recent hospitalization
  • Being immunocompromised or having other associated health conditions

Those at increased risk of resistant bacterial infection and those who do not improve with amoxicillin after three to five days may be given high-dose amoxicillin or high-dose Augmentin ES (amoxicillin-clavulanate).

Alternatives can include Omnicef (cefdinir), Ceftin (cefuroxime), Vantin (cefpodoxime), or, if someone is experiencing vomiting, a shot of Rocephin (ceftriaxone).

For children and adults with a serious allergy to penicillin, Biaxin (clarithromycin), Zithromax (azithromycin), or Cleocin (clindamycin) may be used. Because many bacteria are resistant to older antibiotics, Bactrim (trimethoprim-sulfamethoxazole) and Pediazole (erythromycin-sulfisoxazole) are less likely to be used.

People who don't improve with two antibiotics may be treated with intravenous ceftriaxone or cefotaxime or referred to an ear, nose, and throat (ENT) specialist. Cultures or imaging studies may be done.

In the case of chronic sinusitis, antibiotics may be used if you have a bacterial infection or if your healthcare provider can't rule out an infection. The course of the antibiotics might be extended to four to six weeks.

Antifungal Agents

Antifungal medications are usually not given for allergic fungal sinusitis or non-invasive fungal sinusitis (fungus ball or mycetoma). Antifungal medications may be prescribed for invasive fungal sinusitis, and a surgical procedure may be needed.

Immunotherapy for Allergies

If your sinusitis is caused or worsened by allergies (including fungal allergy), an allergist can give you allergy shots or oral medications to desensitize you to those triggers. These are customized for each person and steadily increase the amount of allergen to reduce your sensitivity.

Desensitization treatment may also be done if aspirin allergy is the cause of their sinusitis.

What is the treatment for a sinus infection while pregnant?

If you are pregnant, your healthcare provider may suggest starting with home remedies like staying hydrated, using a humidifier at night, keeping your head elevated at night, and using saline nose drops or nasal irrigation. Medications like Cefzil (cefprozil) and amoxicillin-clavulanate can help, but these require a prescription from a healthcare provider and should be used with caution since certain drugs can be dangerous while pregnant.

Home Remedies and Lifestyle

Home remedies for sinus infections can greatly reduce symptoms, although they do not treat the infection.

Saltwater nasal irrigation is one of the treatments of choice for the symptoms of chronic sinusitis in adults, though studies show no benefit for children. Nasal irrigation is easy to do at home using a neti pot or other sinus rinse methods.

Using a steam vaporizer or a warm or cool mist humidifier may help keep your mucus thin. Inhalation of steam mixed with eucalyptus, chamomile, or peppermint may also help. While there's no scientific research that these additives improve symptoms, you may find them soothing.

Hot vaporizers are a burn hazard and should not be used near your face or around children.

Try these helpful tips:

  • A hot shower may relieve pain, promote drainage, and open up the sinus cavities.
  • Reduce facial pain and swelling by applying a warm compress to your face.
  • Drink lots of fluids and get plenty of rest. 

Over-the-Counter Therapies

Over-the-counter therapies (OTC) can be used to reduce sinus paincongestion, and for allergy relief. Always check with your healthcare provider or pharmacist before taking a new medication or combining medications, even if they are OTC.

Sinus Pain Relief

Sinusitis can cause headaches, toothache, and pain and pressure in the face.

Over-the-counter pain relievers can be helpful in managing the discomfort and include:

  • Tylenol (acetaminophen)
  • Advil, Motrin (ibuprofen)
  • Aspirin
  • Aleve (naproxen)

Some of these medications can be combined; for example, most healthy adults can take acetaminophen and ibuprofen simultaneously, as long as they follow the dosing instructions included in the package. But ibuprofen and naproxen should not be combined because this may increase the risk of side effects.

Aspirin is a potent blood thinner and you shouldn't take it if you have a bleeding risk or are already taking blood thinners. Aspirin should not be given to children due to the risk of Reye's syndrome.

If your symptoms become worse after taking aspirin or a non-steroidal anti-inflammatory (NSAID), you may have an aspirin intolerance that aggravates the symptoms of sinusitis. Signs include tightness in the chest, wheezing, cough, and sudden nasal congestion within a few hours of taking aspirin, ibuprofen, or naproxen. If you have this condition, avoid taking these medications.

Aspirin intolerance can also be associated with nasal polyps and asthma (Samter's triad).

If over-the-counter pain relievers don't control your pain, consult your healthcare provider.

Nasal Congestion Relief

Nasal congestion, runny nose, and postnasal drip can all be symptoms of sinusitis. Saline nasal spray and Mucinex (guaifenesin) work to thin your mucus and help it drain easier, which may help relieve congestion.

A variety of over-the-counter decongestant medications may help control symptoms of chronic sinusitis. Decongestants are not recommended for adults or children with acute sinusitis, as studies have shown no benefit. Additionally, oral decongestants with the ingredient phenylephrine are not considered effective at clearing up congestion.

Nasal decongestant use should be limited to no more than five days to avoid rebound congestion, which happens when the body increases swelling in reaction to the decongestant wearing off.


Examples of decongestants include:

Always consult with your physician before taking Sudafed or Sudafed PE.

OTC steroid nasal sprays may help treat congestion, especially with chronic sinusitis. These need to be taken over a longer period in order to get the full benefit. They are usually safe to use daily for an extended time, but you should check with your doctor.

They include:

  • Flonase (fluticasone)
  • Nasacort (triamcinolone acetonide)

Antihistamines

Antihistamine medications may work to dry up mucus, and they're most effective for people who develop sinusitis as a result of allergies. These drugs do not pose a risk of rebound congestion. They are not recommended for adults or children with acute bacterial sinusitis.

Some antihistamines cause drowsiness, which may also be beneficial if your symptoms are preventing you from sleeping at night.

If you are looking for an antihistamine that can also help you rest, the following are known for causing drowsiness:

  • Benadryl (diphenhydramine)
  • Unisom (doxylamine)

The following antihistamines are considered non-drowsy:

Antihistamine nasal spray is also available. 

Specialist-Driven Procedures

Enlarged tissues, abnormal growths, scar tissue, and structural abnormalities can block the sinuses and contribute to recurrent and chronic sinus infections. These often require surgery, which may be done by an ENT specialist.

Sinus surgery is done with general anesthesia and is usually minimally invasive and done with an endoscope. A tiny fiber-optic tube is passed through the nostrils into the sinus cavities, and no incision is needed.

While you are usually able to go home the same day, you need to be in the care of another adult for 24 hours and you should not drive.

Some types of sinus surgery that can treat certain causes of chronic sinusitis include the following:

  • Enlarged adenoids in the back of the throat can be removed by an adenoidectomy, which is often performed through the mouth and done as same-day surgery.
  • Turbinates are structures in the nasal passages that warm and humidify the air you breathe. They can become enlarged and may develop an air pocket in the middle turbinate called a concha bullosa. Turbinate reduction can be done with endoscopic surgery.
  • A deviated septum is when the piece of cartilage that divides your nostrils is not centered. A septoplasty surgery repairs this problem.
  • Facial birth defects (such as cleft palate) or injuries can require surgical correction if they are contributing to sinusitis.
  • Nasal polyps are benign masses of tissue that can develop due to inflammation, and contribute to blocking the sinuses and sinusitis. They can be removed with endoscopic surgery.
  • Malignant or benign tumors are less common causes of sinus blockage and can be removed surgically.
  • Fungal sinus infections may require sinus surgery. A fungal ball or invasive fungal infection may not be cleared by antifungal medications alone. Endoscopic surgery can clean out the infectious material and any damaged tissues.

Complementary and  Alternative Medicine (CAM)

Nasal irrigation is one CAM treatment that has become mainstream and is recommended by conventional healthcare providers for adults with sinusitis. Other CAM therapies/approaches may also be suggested, but there's not enough supporting research to recommend them. 

Many alternative healthcare providers believe that food sensitivities can cause sinus congestion and sinusitis, although this is not generally supported by conventional medicine. Sensitivities to dairy, wheat, oranges, or sugar are purported to promote the formation of mucus, and some people may consider removing these foods from their diet to see if it helps.

As with any alternative therapy, it's important to discuss the use of such options with your healthcarecare provider before trying them. 

Self-treating a condition and avoiding or delaying standard care may have significant consequences.

Also, supplements may not be safe for people who are pregnant or nursing, children, and those taking medications that may interact with them.

Summary

Sinus infections are treated in various ways, depending on what's causing them. Some sinus infections don't require any treatment and can be managed at home with remedies like nasal irrigation and cool mist.

When the infection is caused by a bacteria or fungus, you may need a prescription antimicrobial to help clear the infection. In severe cases, you may be prescribed a short course of steroid medication such as prednisone. Sometimes surgery is needed for chronic cases.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Kristin Hayes

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.