Antibiotics for chronic sinusitis in adults

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Antibiotics for sinusitis: TOP effective and inexpensive

Sinusitis is an inflammation of the maxillary sinuses, which can be of a bacterial, allergic, traumatic, or viral nature. It usually develops against the background of colds, acute respiratory viral infections or influenza, but can act as a separate pathology.

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If sinusitis is bacterial in nature, the patient is advised to use antimicrobial drugs. Without their use, the purulent exudate located in the sinuses can “break through”, affecting the human brain. The consequence of this may be encephalitis or meningitis.

When are antibacterial drugs necessary?

Antibiotics are extremely necessary if sinusitis is accompanied by the release of purulent contents of the sinuses from the nasal passages. The group and dosage of the drug can be prescribed exclusively by an otolaryngologist, based on the clinical manifestations of the disease and its severity.

Before using antibiotics, two diagnostic tests are required:

  1. Bacterial inoculation on a nutrient medium, with the help of which the nature of the disease is accurately established, as well as its causative agent (the type of pathogenic microorganisms that caused the development of purulent sinusitis).
  2. Antibioticogram. Such a clinical study determines the sensitivity of a particular type of pathogenic microorganism to certain antibacterial drugs. Thanks to its implementation, the doctor can prescribe exactly the medicine that will give maximum results in the fight against purulent sinusitis.

So, when are antibiotics necessary, and what might be the indications for their use? They are used if sinusitis is accompanied by the following symptoms:

  • pain in the area of ​​the frontal lobes and orbits;
  • pressing sensations in the nose and forehead;
  • a significant increase in body temperature (with acute purulent sinusitis, since chronic sinusitis almost never causes fever, except low-grade fever);
  • copious discharge of purulent exudate;
  • difficulty breathing through the nose, especially at night;
  • intense headaches, which are difficult to get rid of even with the help of potent painkillers;
  • discomfort, pain and pressing sensations in the nose and forehead when bending sideways or to the side.

If therapy is not started in a timely manner, the disease can not only become chronic, but also affect the brain. The consequences of such complications can be unpredictable.

Antibiotic therapy is usually prescribed a week after the onset of the pathological process. It is necessary if nasal rinsing and rinsing, as well as therapeutic inhalations, have not produced any results. Only the attending physician can prescribe an antibacterial drug - you should not self-medicate, since antimicrobial drugs, if used uncontrolled, can cause serious side effects, including angioedema and anaphylactic shock.

What antibiotics will help?

It is impossible to say unambiguously which antimicrobial drugs will be effective in each specific case. It all depends on the results of the antibiogram and bacterial culture for pathogenic microflora. The doctor will prescribe only the antibacterial drug to which the pathogen is most sensitive and has not yet developed resistance. The risk of adverse reactions is also taken into account.

Often, for the treatment of purulent sinusitis, patients are prescribed the use of the following groups of antibiotics:

  1. Penicillin. It is this group of antibacterial drugs that is most often used to treat mild sinusitis. This is due to the low risk of side effects from their use. However, if the disease is severe, such medications will not be effective.
  2. Macrolides. Prescribed in case of intolerance by the patient's body to antimicrobial drugs of the penicillin group.
  3. Fluoroquinols. The advantage of this series of antibacterial drugs is that most pathogenic microorganisms have not yet developed resistance to them. However, due to the fact that such substances are not synthesized in nature, but are manufactured exclusively in the laboratory, and are strictly contraindicated for young children.
  4. Cephalosporins. Such antibiotics are prescribed in extremely difficult situations - if sinusitis threatens to “break through” and affect the brain, or become chronic. They can also be prescribed if other antibacterial agents are ineffective.

Self-medication with antibiotics is dangerous because many patients begin therapy without making sure that they are not allergic to the chosen drug. Allergy tests are a mandatory measure that are always carried out by a doctor before starting treatment for purulent sinusitis in a patient.

List of antibiotics for sinusitis

The choice of antibiotics for the treatment of sinusitis depends on several factors:

  • individual characteristics of the patient’s body;
  • presence of concomitant diseases;
  • the risk of developing allergies or complications after a course of antibiotic therapy (intestinal dysbiosis, etc.).

The selection of the drug is also carried out taking into account the results of a study of a smear of nasal secretions using the Gram staining method.

As a rule, therapy for sinusitis begins with relatively mild penicillin antibiotics. They have a bactericidal effect, achieved by blocking the synthesis of cellular elements of pathogenic microorganisms that cause sinusitis. This leads to the death of pathogenic microflora, resulting in recovery.

List of drugs based on the penicillin series:

  1. Ampicillin sulbactams: Sulbacin, Sultamicillin, Ampisid, etc.
  2. Amoxicillin clavulanates: Amoxiclav, Augmentin, Flemoclav, etc.

Use should be carried out under the close supervision of a physician, especially if treatment is prescribed for a small child. Although penicillins are considered one of the safest antibacterial groups, it never hurts to be safe.

Treatment with macrolides

Macrolides are given special preference because they rank first among antibacterial drugs in terms of their safety. They rarely cause side effects, which explains their popularity and relevance.

These drugs do not block the cell membranes of pathogenic bacteria, but have a bacteriostatic effect, that is, they prevent further proliferation of pathogenic microflora. These properties are especially useful for chronic purulent sinusitis.

Macrolide drugs can be:

  • 14-membered: Erythromycin, Clarithromycin, etc.;
  • 15-membered: the drug Azithromycin and its analogues (azalides) (Sumamed, Azitrus, Zitrolide, etc.);
  • 16-membered: Midecamycin, Spiramycin, Josamycin.

Use of cephalosporins

Cephalosporins have been used for the treatment of sinusitis for a long time, and quite successfully. In addition, microorganisms rarely develop resistance to this group of antibiotics, which is also considered their organizational advantage.

According to generally accepted co-assification, cephalosporins are:

  • 1st generation – Cefazolin, Ceflexin and their analogues;
  • 2 generations – Cefuroxime, Mefoxin, Zinacef, etc.;
  • 3 generations – Cefixime, Ceftriaxone, etc.;
  • 4 generations - Cefpirom, Cefepime, etc.;
  • 5th generation – Ceftolozane, Zaftera, etc.

Use of fluoroquinolones

Fluoroquinolones are synthetic substances that, in their structure and properties, are very different from other groups of antibacterial drugs. When treating sinusitis, these drugs are used only in extreme cases. During pregnancy and lactation they are strictly contraindicated, as they can cause serious harm to the health of the child.

Fluoroquinolones are divided into 4 generations (the list number reflects the generation number of the antibiotics in this series):

  1. Tarivid, Unikpev, Tarivid.
  2. Ciprofloxacin, Norfloxacin, Cifrinol, etc.
  3. Levofloxacin, Ecotsifol, Normax.
  4. Moxifloxacin, Avelox, Gemifloxacin, etc.

An antibacterial drug is prescribed only after collecting the results of a bacteriological nasal smear and an antibioticogram. Within two days after the start of therapy, the first improvement should occur. If this does not happen, the drug is urgently replaced with another.

Systemic antibiotics for sinusitis

Indications for oral or parenteral use of antibacterial drugs in the treatment of purulent sinusitis are:

  • development of intoxication syndrome;
  • prolonged course of the disease;
  • acute catarrhal sinusitis, accompanied by pronounced symptoms;
  • rapid progression of the disease in an acute form;
  • the presence of copious mucous or purulent discharge with severe nasal congestion;
  • severe pain in the maxillary sinuses, eyes, frontal lobes, cheekbones;
  • development of complications of sinusitis, expressed through otitis, periostitis of the upper segment of the jaw, addition of a secondary infection, etc.

Oral and parenteral administration of antibiotics often causes complications in the form of allergic reactions and intestinal dysbiosis. For this reason, the patient must be prescribed probiotics in parallel.

Injectable drugs

The most optimal option for antibacterial agents for sinusitis, dispensed in the form of solutions for intramuscular injections, is considered to be the cephalosporin group. If we talk about specific medications, the drugs Cefazolin and Ceftriaxone are often used for this purpose. Despite the similarity in the principle of influencing pathogenic microflora, these agents also have some differences.

  1. Ceftriaxone is a dry powder, dispensed in ampoules, and intended for the preparation of a solution for intramuscular or intravenous administration. It is used for severe sinusitis and has a powerful bactericidal effect. The powder is diluted with water for injection or lidocaine solution (painkiller). This medicine is extremely necessary in the presence of purulent contents of the maxillary sinuses. Progress is noted after 2-3 injections.
  2. Cefazolin is also available in powder form for the preparation of an injection solution. Diluted with sodium chloride or water for injection. It is used for the treatment of acute sinusitis without pronounced complications. A significant drawback of the drug is its ability to cause severe allergic reactions, so it is used with extreme caution to treat young children.

The main difference between Ceftriaxone and Cefazolin is that this drug has a more powerful effect. Both injections are very painful, but Ceftriaxone still causes a more intense pain syndrome, so the powder is diluted with lidocaine.

Local treatment

Systemic administration of antibacterial drugs is often carried out in combination with special solutions for treating the nasal cavity. Here is a list of the most effective drugs.

  1. Polydexa. This antibiotic is used extremely rarely to treat the nasal passages because it can cause serious side effects. It contains neomycin and polymyxin B. However, the spray gives good results in the treatment of sinusitis and purulent sinusitis, and also prevents the development of complications of the disease and the addition of a secondary infection.
  2. Biparox is an antibacterial drug for topical use in the treatment of sinusitis. Dispensed in the form of an aerosol with a dispenser for spraying the medicine into the nasal passages. The active substance is fusafungine. This polypeptide antibiotic copes well with various pathogenic microflora: pathogenic bacteria, fungi, mycoplasma, etc. At the same time, it has an anti-inflammatory effect.
  3. Isofra is another highly effective antibacterial agent for combating acute manifestations of sinusitis. The active substance is the aminoglycoside framycetin. The spray copes well with inflammatory processes occurring in the paranasal sinuses.

Another widely used aminoglycoside antibiotic intended for topical use is Taizomed. The drug contains the active component torbamycin. This is a broad-spectrum drug that has a powerful antimicrobial effect.

Contraindications and side effects

Antibiotics should not be used to treat sinusitis if:

  • presence of allergic reactions;
  • pregnancy (without a doctor’s prescription) (see first signs of pregnancy);
  • renal failure (drugs Flemoxin, Sumamed, Zitrolide);
  • liver dysfunction (Amoxiclav).

Other contraindications to the treatment of sinusitis with antimicrobial drugs are:

  • lymphocytic leukemia;
  • Infectious mononucleosis;
  • children under 12 years of age;
  • impaired blood clotting;
  • tendency to open bleeding.

If used incorrectly or overdosed with antibacterial drugs, side effects may occur in the form of nausea, vomiting, slight rise in body temperature, skin flushing, itching, urticaria, headaches, dizziness, stool disorders, and sleep problems. Children may develop conjunctivitis, their general health may deteriorate, and migraines may occur. To avoid this, take the medications prescribed by your doctor correctly!

Are there antibiotics for children?

It is not antibiotics that are “adult” or “children”, but the dosage of a particular drug. Treatment of sinusitis in young patients is mainly based on the local use of antimicrobial agents. Basically, these are drops or sprays.

There are other “children’s” forms of antibiotics:

  • suspensions for oral administration;
  • tablets (from 12 years and older);
  • injections.

Only an ENT specialist, a family doctor or a pediatrician can select a specific drug and prescribe its dosage. Doctors often recommend treating sinusitis in children with the drugs Isofra, Summed, Polydex, etc. Previously, Bioparox was used for this purpose, but now it is prohibited.

It is very important to correctly approach the use of antibiotics prescribed by a doctor for sinusitis. Their prescription should always be accompanied by additional prescription of antihistamines, antiallergic and anti-edematous medications. This could be Allerdez, L-Cet, children's Loratadine, etc. Suspensions and syrups are used for children, and tablets for older children. After completing therapy, it is advisable to take antiallergic drugs for a few more days to consolidate the effect.

The main mistake of most parents is trying to self-medicate sinusitis in a child. Folk remedies, of course, quite often give positive results in the fight against pathology, but they can also cause harm. Many alternative medicine recipes only temporarily postpone the problem, but do not help to get rid of it completely. Therefore, remember: no one can prescribe the most effective remedy for sinusitis - only a qualified otolaryngologist!

Conclusion

Sinusitis is a very dangerous and insidious disease that can cause a number of complications. It can develop gradually or progress rapidly.

The feasibility of using antibiotics and the choice of a specific drug depends on its stage. However, this can only be judged by the attending physician, so do not risk your health by not wanting to stand in line to see an otolaryngologist. Be healthy!

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Sinusitis: treatment with antibiotics. Name, drops, tablets

Sinusitis is a disease characterized by inflammation of the maxillary sinuses. It is one of the types of sinusitis, acute or chronic in nature. In this case, the inflammation occurs in the maxillary sinus; in medical practice it is called the maxillary sinus.

In acute sinusitis, inflammation occurs in some epithelial cells, blood vessels and loose tissue.

In the case of chronic sinusitis, the inflammatory process involves the submucosa and spreads to the bony part of the sinus.

Note that there is no difference between sinusitis and sinusitis, so often in the patient’s medical history you can find a diagnosis of maxillary sinusitis. Sinusitis is one of the types of sinusitis.

This disease can affect patients of any age and most often in the autumn-winter period.

What are the causes of sinusitis?

Treatment of the disease is slightly complicated by the fact that many factors can cause its development. The development of pathology in adults is primarily influenced by the presence of upper respiratory tract infections. Often the illness is a consequence of acute respiratory infections or influenza, as well as other viral diseases.

There are a number of factors:

  • pathologies in which nasal breathing is difficult (rhinitis, deviated septum, as one of the symptoms of allergies, etc.);
  • conditions in which immunity is significantly impaired (infectious or parasitic diseases, previous operations, etc.);
  • activation of staphylococcus in connection with the development of an infectious disease;
  • defects of the nasal cavity associated with anatomy.

As mentioned above, the main reason is viral and infectious diseases such as acute respiratory infections. Some bacteria can also cause pathology: mycoplasma, chlamydia, staphylococcus and streptococcus.

If we talk about children, then most often the cause of sinusitis is mycoplasmosis and chlamydia. In this case, treatment will be based on the use of macrolide drugs.

The second, far from rare cause of sinusitis, can be diseases of the ENT organs. In this case, we are talking about chronic rhinitis, which clogs the outlet, thereby contributing to the development of sinusitis. Blockage occurs due to swelling of the nasal mucosa. Therefore, for rhinitis, adrenergic agonists are recommended to relieve swelling of the mucous membrane.

Pharyngitis can also cause the development of sinusitis, as it acts as an infectious source.

Less commonly, the cause may be a deviated nasal septum, namely a violation of ventilation. In this case, drug treatment will not be effective, since this cause tends to cause relapses. The only solution is to undergo surgery to correct the nasal septum.

It is necessary to mention other possible culprits for the development of sinusitis - this is pulpitis or the last stages of caries. Inflammation occurs due to the spread of infection from the diseased tooth to the maxillary sinuses.

Recently, in medical practice, sinusitis occurs due to an allergic reaction. Rhinitis can often accompany this course of the disease.

We should not forget about chronic sinusitis, which is a consequence of untreated sinusitis.

Clinical signs can be ambiguous and do not always give reason to think about the presence of an inflammatory process.

Sinusitis: treatment with antibiotics

The first signs and symptoms of the acute course of the disease are a feeling of compression in the nasal septum and pain, which is often observed in the forehead area. Often, such pain can spread to half the face and even to the back of the head.

When you tilt your head down, you may feel that the discomfort intensifies. Pain in the frontal part of the head may be less intense in the morning and increase at night.

Headache may accompany the patient throughout the day. This is due to the accumulation of pus in the maxillary sinus.

The second symptom of sinusitis is a runny nose. Most often, the discharge is purulent in nature, with a color ranging from dark yellow to green.

The next thing that can be observed is a rise in temperature and malaise. For this reason, sinusitis is often confused with regular flu or acute respiratory infections.

Acute sinusitis lasts up to 3 weeks, but often with proper and timely treatment it ends in recovery.

Chronic sinusitis is characterized by mild symptoms, which often slows down the treatment process. The only symptom that should alert you is a persistent runny nose that cannot be treated locally. Sometimes there may be pain that migrates from the area of ​​the eye sockets to the back of the head.

What antibiotics to take for sinusitis in adults?

The prescription of antibacterial therapy is the basis in the treatment of lesions of the upper respiratory tract, as well as other infectious diseases. The goal of antibiotic therapy is to suppress the development of bacteria.

Antibiotics are used both for acute forms of pathology and for chronic cases. If the doctor diagnoses acute sinusitis, an increased dose of antibiotic is prescribed; the treatment itself lasts no more than 7 days. Chronic sinusitis requires longer treatment, sometimes up to 4 weeks.

Antibiotic therapy involves not only eliminating the infection, but also preventing complications. And also, if local drugs do not help in treating the disease.

We should not forget that all antibiotics should be taken strictly as recommended by a doctor, especially when treating children and pregnant women. It is believed that the injectable form of antibiotics is the most effective, however, there are a number of tablet preparations that are no less effective.

Below we will consider the main drugs and treatment methods that are prescribed for the treatment of sinusitis (sinusitis).

Macrolide drugs

These are the safest, but no less effective drugs. Prevents the growth of bacteria and the development of infection, suitable for both acute and chronic disease. The most popular medications in this group are the following:

Azithromycin. Not an expensive drug, it has an antimicrobial effect. Not recommended for people with liver disease or a possible allergy to one of the components of the medicine. Erythromycin. The action is similar to penicillins. Not effective against gram-negative microorganisms. It does not have many side effects, and is often prescribed to patients with allergies to penicillin drugs.

Betalactam agents

Another equally well-known antibiotics - drugs of the beta-lactam group, have a natural basis. They are quite gentle with a minimum of side effects, but are active against limited types of bacteria.

Amoxicillin. Quite effectively destroys streptococci and gram-negative bacilli. It is a gentle drug because it does not have a negative effect on the body. However, it is intended for short-term use, since bacterial agents quickly adapt to the active substance of this drug. Augmentin. Refers to protected penicillins (with the addition of clavuanic acid). Actively inhibits bacterial growth and is a broad-spectrum antibiotic. With the correct dosage it does not cause severe side effects.

Cephalosporin series

Cephalosporins actually belong to the penicillin series, but are more effective. Drugs in this group actively destroy bacteria that develop during sinusitis. Today, the most famous is ceftriaxone, which is a 3rd generation antibiotic.

Ceftriaxone. A popular drug, it has a wide spectrum and effectively acts on pathogenic flora. Often prescribed for sinusitis, however, the drug has quite a lot of side effects. Therefore, treatment with this medicine is not recommended during pregnancy and children.

Sometimes a specialist may prescribe drugs of the tetracycline group. They have an antimicrobial effect, but are intended for topical use only. For this reason, they are used as independent means for treatment. It is advisable to prescribe as an additional drug.

It is important to remember that treatment with medications should be carried out under the supervision of an ENT doctor. Be sure to take only the prescribed course of antimicrobial drugs, follow the dosage, and if side effects occur, immediately contact your doctor.

Antibiotics for sinusitis in children

Illness in a child must be treated with extreme caution. Only in exceptional cases will the doctor prescribe the antibiotics described above and in cases where treatment with other methods has not been effective.

The child’s body is quite fragile and taking broad-spectrum antibiotics can negatively affect liver function and also disrupt the microflora of the gastrointestinal tract. In addition, there are a number of reasons that do not allow taking antibiotics:

  • in cases where sinusitis has developed against the background of a viral infection;
  • the cause of the disease was a fungus;
  • sinusitis (sinusitis) as a residual phenomenon of allergy;
  • the pathology is mild, which does not require the use of antibiotics.

Therefore, when treating children, doctors are increasingly recommending modern local remedies. They effectively eliminate the infection, but do not have any side effects on the baby’s body.

Recently, the drug Bioparox in the form of an inhaler and its analogue, Hexoral, have become very popular. They are effective antibiotics for topical use. Indispensable in the treatment of sore throat, sinusitis and sinusitis in children; they do not cause side effects. The therapeutic effect is observed after 7-10 days.

Sinusitis during pregnancy: treatment

Any disease during pregnancy becomes a real test for the expectant mother. After all, almost all drugs are not recommended for use while carrying a child.

Therefore, very often such patients try to resort to treatment using folk remedies - tinctures, decoctions, they are used as independent remedies. And this is the main mistake that should not be made.

It is worth understanding that during pregnancy, any infection is more dangerous than taking antibiotics itself, both for mother and child. For this reason, treatment of sinusitis should be timely, correct and with minimal use of medications.

There are certain treatment methods during pregnancy:

  • rinsing the maxillary sinuses;
  • the use of traditional medicine in combination with other treatment methods;
  • drug treatment;
  • antimicrobial agents for topical use;
  • homeopathy;
  • conservative treatment (puncture of the maxillary sinuses).

Nasal rinsing for expectant mothers with sinusitis

The most gentle method of therapy. The idea is to rinse the maxillary sinuses using liquid. The patient is placed on her back, with her head slightly lower than her body.

A special solution is poured into one nostril, and at the same time a device is connected to suction the liquid. In this way, accumulated pus is removed.

Traditional medicine should be used as a complement to the main treatment with antibiotics or local drugs. Thus, decoctions of medicinal herbs are often used for washing, described above.

How to treat sinusitis with medications (antibiotics)

Prescribing drug therapy during pregnancy requires special attention. It is advisable to prescribe it in cases where the risk of treatment is significantly less, and the benefits are many times greater. Today, pharmacology has gone far ahead and is creating drugs that are approved for use during pregnancy. Among them are the following:

  • Augmentin;
  • Drugs of the cephalosporin group;
  • In severe cases of the disease - Spiramycin.

Another equally effective remedy is Sinupret. It actively inhibits the growth of bacteria and helps to liquefy the contents of the sinuses. Contains extracts from medicinal herbs, which significantly reduces the risk of negative effects on the expectant mother and fetus.

Preparations for topical use

The main task of such drugs is to relieve swelling and are available in the form of drops or sprays. Additionally, they have a vasoconstrictor effect. The most famous are: Nazivin and Otrivin. But, during pregnancy, the use of such drugs cannot be recommended.

Homeopathy for sinusitis

Homeopathic preparations can be a good replacement for antibiotics or antimicrobial agents. However, it should be remembered that the drugs in this group are less effective, and their therapeutic effect is much longer than that of antibiotics.

Note that most drugs in this group should be used for a course of up to 3 months. Homeopathy is designed to stimulate the immune system rather than to fully treat sinusitis. Most often, the following remedies are recommended:

Puncture (puncture) of the maxillary sinuses

In some cases, puncture of the maxillary sinuses may be required as the most acceptable and non-alternative method of treating sinusitis. The puncture involves removing pus after puncture with a special needle and injecting a solution. The procedure allows you to relieve swelling of the mucous membrane, eliminate pus and reduce headaches.

Treatment of sinusitis in infants

Most often, the root cause of the disease in infants is an advanced form of the runny nose. Often, this pathology affects children prone to allergies of various kinds.

Infants may be prescribed drops with antibiotics, for example, Isofra and Polydex. Treatment of pathology in infants up to 3 months is exclusively with drops; preparations in the form of a spray are used no earlier than from 2 years.

In some cases, the doctor may prescribe the use of a penicillin drug, Amoxicillin. Infants up to 12 months are prescribed pomg of the drug per 1 kg of weight.

For example, if a child weighs 3 kg, then the dose of the drug will be: 75 mg 3 times a day. For infants, the antibiotic is prescribed in the form of a suspension, which must be mixed with breast milk or baby food.

Penicillin drugs, like other antibiotics, have an increased allergic reaction towards infants. Therefore, treatment of sinusitis may be accompanied by redness on the skin or hives. This effect requires discontinuation of the drug and contacting your doctor.

Antibiotic release form

Antibiotics for the treatment of diseases such as sinusitis (sinusitis) are available in the following forms:

The doctor determines which form of antibiotic to choose based on the patient’s age and symptoms. If the patient is an adult or a teenager, then this can be in tablet form or injections.

Tablet therapy is prohibited for small children and infants; it is advisable to prescribe antibiotic-based drops or sprays.

How to take antibiotics correctly for sinusitis?

The use of antibiotics for sinusitis (sinusitis) can be prescribed: in the form of injections (injections), orally (capsules, tablets), local administration (drops, inhalations). If the disease is of moderate severity, then you can get by with taking pills.

A more severe form of the disease will require the administration of drugs intravenously or intramuscularly. As the symptoms weaken and the condition improves, the patient is transferred to the tablet form.

The use of antibiotics requires compliance with certain rules:

  1. strictly adhere to the prescribed dose and time between doses;
  2. It is necessary to take any antibiotics only according to the course prescribed by the doctor;
  3. If side effects of any severity occur, you should stop taking the drug and consult a doctor.

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What are the symptoms of sinusitis? Diagnosis at home

The development of the disease can be assumed based on the following main signs:

  • feeling of nasal congestion, difficulty breathing;
  • aching pain in the bridge of the nose, which can migrate to the frontal and occipital parts;
  • during the development of the disease, greenish nasal discharge can be observed;
  • temperature rise to 39 degrees.
  • These are the first signs by which one can suspect the development of pathology.

The next step is to contact an ENT specialist, who will examine you in more detail and prescribe appropriate treatment. The most informative method for diagnosing sinusitis is an x-ray of the maxillary sinuses. The image allows you to accurately see the presence of an inflammatory process.

In some cases, puncture is prescribed as a method for diagnosing sinusitis (sinusitis). With the help of a puncture and suction of the contents, the doctor can easily establish a diagnosis.

Sinusitis is not such a harmless disease as it might seem at first glance. Why are such diseases dangerous? The main danger is that against the background of infection, the process of formation of pus in the sinuses starts, hence the high risk of developing meningitis.

With timely treatment, such a complication occurs quite rarely. But, in some cases, the infection can affect the orbital area, which leads to swelling and severe pain.

Chronic sinusitis is the cause of frequent colds, as well as sore throat, acute pharyngitis and dental pathologies.

Untreated sinusitis often causes the development of chronic rhinitis, which can subsequently negatively affect the sense of smell, up to its complete loss.

Therefore, antibiotic therapy in most cases is the only way to get rid of the disease.

Sinusitis treatment with antibiotics: video

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That is why treatment of sinusitis with antibiotics becomes necessary in severe forms of the disease in order to avoid serious danger to the patient’s life and prevent the disease from becoming chronic.

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Specialty: Otorhinolaryngologist Work experience: 12 years

Specialty: Otorhinolaryngologist Work experience: 8 years

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Antibiotics for sinusitis

Sinusitis is a catarrhal or purulent inflammation of the paranasal sinuses, which in most cases develops as a result of improper treatment of acute infectious and inflammatory pathological processes of the nasopharynx, complications of chronic inflammation of the upper respiratory tract or colds against the background of immune system disorders.

This disease occurs when pathogenic microorganisms multiply in the maxillary sinuses, due to their entry into the nasal cavity through the lymphogenous or hematogenous route (through lymph or blood) or through breathing.

Symptoms of sinusitis

Acute or chronic inflammation of the maxillary sinuses is characterized by certain symptoms:

  • headache radiating to the teeth with increased pain in the evening;
  • mucopurulent or purulent discharge from the nose or its outflow along the back wall of the nasopharynx;
  • persistent nasal congestion with a characteristic “in-the-nose” tone of voice;
  • decreased sense of smell on the side of the affected sinus;
  • a feeling of squeezing and/or heaviness in the face with pain when pressing on the area of ​​the maxillary sinuses (paranasal region, cheeks, brow ridges);
  • general weakness, malaise and worsening symptoms of a viral infection a week after starting treatment.

Main aspects of treatment of sinusitis

Treatment of this disease is carried out only when the diagnosis is clarified, which is determined on the basis of both a clinical examination of the patient and mandatory instrumental confirmation of the pathological process in the maxillary sinuses - computed tomography, ultrasound examination of the nasal cavity or radiography of the paranasal sinuses of the skull.

Correct, adequate and timely treatment of sinusitis is considered to prevent their complicated course and the spread of the infectious process to nearby organs and systems:

  • brain (with the development of meningitis, meningoencephalitis, brain abscesses, inflammation of the veins of the dura mater);
  • organs of vision (eyeball and its appendages) with the emergence and progression of reactive edema of the tissue of the eyelids and/or orbit, purulent-inflammatory processes in the bone walls and soft tissues of the orbit, retrobulbar abscess and thrombosis of its veins;
  • organ of hearing with the development of otitis, labyrinthitis and neuritis of the auditory nerve;
  • spread of infection through the blood and lymphatic vessels to distant organs, causing infectious-allergic inflammatory reactions, myocarditis, nephritis, rheumatism of the heart and nervous system, osteomyelitis, hepatitis, trigeminal neuritis.

Traditional methods of treating an infectious-inflammatory process in the maxillary sinuses are based on individual complex drug therapy, which includes:

  • antibiotics;
  • mucolytics;
  • decongestant and anti-inflammatory local medications;
  • symptomatic treatment (analgesics, detoxification therapy, antihistamines);
  • antiviral agents (if sinusitis develops against the background of a viral infection);
  • restorative therapy (herbal adaptogens, vitamins, immunomodulators).

As well as rinsing the nasal cavity, physiotherapeutic procedures and puncture of the maxillary sinus if indicated.

Indications for the use of antibiotics for sinusitis

Antibiotic therapy for sinusitis today is prescribed by otolaryngologists quite often, but only if the cause of acute or protracted sinusitis is a bacterial infection. In this case, before starting treatment with antibacterial drugs, a bacteriological culture from the nose is performed to determine the sensitivity and resistance of pathogenic microorganisms that caused the inflammatory process.

Also, when choosing an antibacterial drug, it is necessary to take into account the individual characteristics of the patient, concomitant diseases, possible allergic reactions to antibiotics and other drugs so that the treatment of sinusitis with antibiotics is effective, with minimal risks to the health of patients and does not become a waste of money and time.

As a rule, at the initial stage of sinusitis without the presence of purulent discharge from the nose, a pronounced disturbance in the general well-being of the patient and persistent pain syndrome, otolaryngologists monitor the course of the disease and are in no hurry to immediately prescribe antibiotics or begin with the use of local complex medicines that also contain antibacterial components . These drugs include Bioparox, Isofra, Polydexa. But when there is abundant purulent discharge, persistent nasal congestion, pain in the maxillary sinuses and symptoms of intoxication (lethargy, fever, headache), which intensify, it is necessary to prescribe antibiotics orally or parenterally. Most often, antibacterial drugs from the group of penicillins, macrolides and cephalosporins are used to treat sinusitis. In severe forms and protracted course of acute sinusitis, antibiotics from the group of fluoroquinolones and, less commonly, aminoglycosides are prescribed.

Lack of advisability of taking antibiotics for sinusitis

To determine the need to prescribe antibiotics for the development of sinusitis, it is necessary to determine the cause of sinusitis and/or its causative agent due to the fact that antibacterial therapy in the presence of certain provoking factors can not only become an ineffective method, but also aggravate inflammation, as well as provoke a protracted course of the disease and slow down the healing process.

  • with sinusitis of allergic origin;
  • for acute sinusitis caused by a viral infection;
  • in case of chronic sinusitis, which develops as a result of viral-fungal associations or fungal etiology - in this case, taking broad-spectrum antibacterial drugs will exacerbate the process and can cause dysbiosis of the mucous membranes of the nasopharynx and paranasal sinuses.

For mild viral sinusitis, the most effective treatment methods are nasal lavage in combination with inhalations, mucolytics and immunotherapy.

It is important to remember that the prescription of therapy for the treatment of sinusitis, as well as other types of sinusitis, is prescribed only by a specialist, is complex and individual, taking into account the characteristics of the patient (age, concomitant diseases, allergic reactions), the microflora that caused the inflammatory process and the immunological reactivity of the body.

Taking antibiotics quite often does not leave its mark on the body and is used only in cases of extreme necessity, and pronounced negative side reactions can occur when the dose and frequency of taking these medications is exceeded as a result of self-medication or when they are used uncontrolled. Also, all antibiotics, to a greater or lesser extent, suppress the immune system of patients and can provoke changes in the normal microflora of the intestines, vagina, mouth and the development or progression of dysbiosis and fungal diseases. In all these pathological processes, they manifest themselves in the form of an unpleasant taste in the mouth, aphthous stomatitis, stomach and intestinal disorders with diarrhea of ​​varying severity and symptoms of vaginal fungal infections (thrush).

Features in the treatment of sinusitis with antibiotics

1. Antibiotics should be taken only after consulting an ENT doctor (upon clarifying the diagnosis) and in accordance with his recommendations - doses, frequency and duration of use. You should not stop taking these medications when the first symptoms of improvement appear or when symptoms completely disappear due to a possible relapse of the disease.

2. An important aspect of the effectiveness of antibacterial drugs is the discharge of purulent discharge from the nasal sinuses, which is achieved by the combined use of vasoconstrictors and decongestants, mucolytic drugs (to thin out viscous mucus) and rinsing the nasal cavity with antiseptic solutions.

3. To prevent dysbiosis and the addition of a fungal infection, the joint administration of probiotics is necessary.

4. The use of the latest technologies for the treatment of sinusitis as prescribed by an otolaryngologist - a special catheter for the paranasal sinuses "YAMIK", laser therapy and the herbal homeopathic drug Sinuforte, which cleanse the maxillary sinuses and increase local immunity.

Local antibiotic treatment of sinusitis

Topical antibacterial medications include nasal drops or nasal sprays containing antibiotics. The most widely used today are Isofra, Polydexa and Bioparox.

Polydexa

Polydexa is a modern complex drug for the effective treatment of purulent complications in otolaryngology, including sinusitis (sinusitis, ethmoiditis and frontal sinusitis) of microbial etiology. This drug has a pronounced anti-inflammatory effect with significant inhibition and/or destruction of bacterial microflora and purulent complications are completely cured.

The effectiveness of this local antibacterial drug is determined by its composition:

  • two antibacterial drugs – neomycin and polymyxin, which activate each other’s actions;
  • dexamethasone is a hormonal anti-inflammatory component;
  • phenylephrine is a vasoconstrictor drug (anticongestant) from the group of alpha-adrenomimetic drugs.

Polydexa has an antimicrobial and bactericidal effect with a strong anti-inflammatory effect for the local treatment of sinusitis.

It is important to remember that the need to use this antibiotic-containing drug can only be decided by the attending otolaryngologist after examination and with a confirmed diagnosis of sinusitis.

Absolute contraindications to the use of Polydex nasal drops are:

  • children under 2 years of age;
  • increased individual sensitivity to one of the main components (neomycin, polymyxin and dexamethasone) or excipients of this drug;
  • suspicion of angle-closure glaucoma;
  • simultaneous use of this drug with monoamine oxidase inhibitors;
  • viral diseases of the nasopharynx;
  • period of pregnancy or while breastfeeding;
  • albuminuria syndrome in severe kidney disease.

The prescription of Polydexa for the treatment of sinusitis in professional athletes often causes positive reactions in doping tests.

Polydex is prescribed with extreme caution when used simultaneously with attenuated live vaccines BCG and BCG-M (anti-tuberculosis) and polio, which is associated with a high risk of developing these dangerous diseases against the background of generalization of the infection, therefore vaccination is transferred and carried out only after the patient has been completely cured. Also, Polydex is not used with aminoglycoside antibiotics, which have a pronounced ototoxic effect, especially with combined complications such as otitis or labyrinthitis.

Polydexa has a complex composition and its independent use is strictly prohibited - treatment with this drug can only be started after examination by an ENT doctor, family doctor, internist and pediatrician and under mandatory dynamic observation with individual doses, frequency of administration and duration of therapy, concomitant diseases and immunological reactivity of the patient's body.

In severe cases, local use of Polydex is combined with oral antibiotics or their parenteral administration.

Bioparox

Bioparox is currently a new generation drug, which is considered quite effective if there are indications for its local use in the form of severe infectious and inflammatory diseases of the nose - sinusitis.

This antibacterial drug is available in the form of an aerosol (spray) for local use in the nasopharynx (with two nozzles - for the nose and throat separately). Bioparox is available in 20 ml bottles containing 400 doses of the drug. The active ingredient in the spray is the topical antibiotic fusafungin. The effective therapeutic effect of this drug is based on a double effect, which consists of the simultaneous antimicrobial and anti-inflammatory effects of fusafungin. It is active against staphylococci, group A streptococci, pneumococci, some strains of nonseria and anaerobes, as well as mycoplasma and fungi of the genus Candida, which in most cases are the causative agents of both secondary sinusitis (when pathogenic microflora is attached to the background of viral and colds), and and primary sinusitis, which develop with the activation of the own microflora of the nasopharynx and paranasal sinuses against the background of a decrease in the local immune reactivity of the mucous membranes or with the progression of concomitant infectious and allergic processes in the body.

When used correctly, Bioparox, in the form of tiny particles, actively penetrates deep into the walls of the nasopharynx and sinuses, relieving swelling and inflammation of the mucous membranes, improving the outflow of mucus from the nose and causing the death of pathogens of the infectious process. At the same time, Bioparox has minimal systemic effects and is found in blood plasma in small quantities. But at the same time, it is used with caution during pregnancy and lactation - in these conditions, even a small amount of fusafungine in the blood can have a general adverse effect on the fetus and infant.

It is also important to remember that Bioparox for sinusitis in the form of monotherapy can be effective only at the beginning of the disease, when the inflammatory process is catarrhal in nature. Acute purulent sinusitis and its protracted forms are difficult to treat with Bioparox alone; complex therapy is used, which is prescribed by a specialist. Self-medication in this case can lead to the progression of the disease, the addition of other catarrhal or purulent inflammations, the development of resistance of pathogenic microflora, dysbacteriosis or the layering of a fungal infection, which significantly complicates the cure and can lead to the transition of sinusitis to a chronic form.

Adverse reactions when using Bioparox occur rarely, but can manifest themselves in the form of local allergic reactions on the skin and mucous membranes, which manifest themselves in the form of an allergic rash or swelling, discomfort in the paranasal sinuses, burning and redness of the nasopharyngeal mucosa. Less commonly, an allergic reaction manifests itself in the form of bronchospasm and angioedema.

Isofra

Isofra nasal spray is an antibacterial drug that contains framycetin sulfate, an aminoglycoside antibiotic.

Isofra is produced in the form of a nasal aerosol and is used in the form of intranasal injections using a nebulizer, as a result of which the antibacterial agent is sprayed and absorbed into the mucous membrane of the nasal passages and the uniform distribution of microparticles of the active substance framycetin sulfate with the penetration of the antibiotic even into hard-to-reach areas of the paranasal sinuses during sinusitis .

This drug is often prescribed as part of combination therapy in the treatment of bacterial sinusitis caused by Haemophileus influenza, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae in the absence of violation of the integrity of the walls of the paranasal sinuses and nasal septum, which is an important condition that is taken into account when prescribing Isofra. The drug is strictly contraindicated for use when washing the maxillary sinuses during puncture. Isofra is ineffective in the treatment of infectious and inflammatory processes caused by S. pneumoniae, S. maltopilia and B.cepacia, like most antibiotics from the aminoglycoside group.

It is important to remember that this drug is an antibacterial drug for the treatment of purulent, mucopurulent or catarrhal complications of a viral infection in the form of sinusitis (sinusitis, ethmoiditis and frontal sinusitis). The effectiveness of these drugs can be determined only after an antibiogram as a result of bacteriological cultures of the nasal cavity and sinuses with determination of the pathogenic pathogen and its sensitivity to the antibiotic.

Untimely and/or incorrect use of this drug will, at best, be ineffective (provided the microflora is resistant), but can lead to a complicated course of sinusitis and negative effects on the body as a whole when taken simultaneously with incompatible drugs (ototoxic antibiotics, MAO inhibitors, antiarrhythmic drugs, non-steroidal anti-inflammatory drugs). And also cause the development of dysbacteriosis, layers of fungal infection, congenital anomalies of the fetus when used during pregnancy, aggravation of concomitant somatic pathology (with vasculitis, severe diseases of the blood, kidneys or liver).

It is important to remember that even topical antibiotics are prescribed only by a specialist, and self-medication in this case does more harm than good in most cases.

Systemic antibiotics for sinusitis

Oral or parenteral prescription of antibiotics as part of complex therapy is carried out:

  • with acute catarrhal sinusitis with a pronounced clinical picture and progression of the process;
  • with profuse mucopurulent or purulent discharge from the nose with severe nasal congestion;
  • with severe pain syndrome, which is manifested by persistent headache and pain syndrome in the projection of the maxillary sinuses, upper jaw, cheeks, brow ridges;
  • in the presence of intoxication syndrome;
  • with prolonged course of sinusitis;
  • with multiple purulent complications in the form of sinusitis, otitis, labyrinthitis, reactive edema of the tissue of the eyelids and/or orbit, periostitis of the upper jaw, odontogenic sinusitis (as a result of complicated caries of the upper teeth), associations of microbial flora (several pathogens);
  • or a combination of several of the above aspects.

Most often, antibacterial drugs from the group of cephalosporins, penicillins, macrolides and fluoroquinolones are used to treat sinusitis.

Penicillin antibiotics

(Amoxicillin, Flemoxin Solutab, Hiconcil, Flemoclav Solutab and protected amoxicillins - Amoxiclav and Augmentin).

Penicillin antibiotics - for sinusitis, aminopenicillins are more often used, which are today the best antibacterial drugs for the treatment of infectious and inflammatory pathological processes in the paranasal sinuses:

  • they have fewer side effects;
  • easy to carry;
  • aminopenicillins are effective against gram-positive cocci (staphylo-, pneumo- and enterococci) and less effective against streptococci. Also, these drugs are highly effective against gram-negative microorganisms of the intestinal group (Shigella, Salmonella, Escherichia coli) and Haemophilus influenzae.

But in the presence of a severe inflammatory process caused by penicillin-resistant infections (staphylococci, gonococci, Haemophilus influenzae producing beta-lactamases), they may be ineffective, and therefore protected aminopenicillins are used in combination with clavulonic acid (Amoxiclav) or sulbactam ( Augmentin).

Any of these drugs is prescribed only by the attending physician, taking into account the individual characteristics of the patient and the course of the disease.

Drugs from the aminopenicillin group are low-toxic antibiotics, but sometimes adverse reactions may occur:

  • allergic manifestations (skin rash, bronchospasm, angioedema or anaphylactic shock);
  • disturbances of water and electrolyte balance (hypokalemia or hypernatremia);
  • hematological reactions (anemia, neutropenia, thrombocytopenia);
  • vascular complications;
  • increased activity of liver transaminases;
  • neurotoxicity (tremor, convulsions, severe headache);
  • psychopathic reactions (increased anxiety, sleep disturbances).

Cephalosporins

(Cefuroxime, Cefixime, Ceftibuten, Zinnat, Ospexin, Cefutil, Cefotaxime, Cefix, Cedex)

This group of antibiotics is prescribed orally and parenterally for severe inflammation and/or when other antimicrobial agents are ineffective.

The pharmacological effect of all cephalosporin antibiotics is bactericidal. The basis of their therapeutic action is the inhibition of metabolic processes in the cell wall of the pathogen, as a result of which lysis of bacteria occurs under the influence of intracellular osmotic pressure and the death of microorganisms.

Due to their high bactericidal activity, these antibiotics are used in complex treatment regimens for sinusitis in adults and children in outpatient settings and in hospitals.

The most common side effects observed with the use of cephalosporins are allergic (urticaria, erythema multiforme, angioedema), hematological reactions and effects on the digestive tract (abdominal pain, nausea, diarrhea, pseudomembranous colitis).

Macrolides

(Macropen, Zitrolide, Clarithromycin, Azithromycin, Josamycin)

The use of these antibiotics is especially effective for infections that are difficult to treat with other antibacterial drugs and/or with intolerance to penicillin and cephalosporin antibiotics. Their pharmacological effect is due to a bacteriostatic effect caused by disruption of protein synthesis in microbial cells. Along with the antimicrobial effect, macrolides have high anti-inflammatory activity.

These antibiotics are classified as tissue antibiotics, due to their rapid distribution in tissues with a particular affinity for the epithelium of the paranasal sinuses, ears, lung tissue, gastrointestinal mucosa and skin. They also penetrate into cells creating a high intracellular concentration.

The combination of macrolides with penicillin antibiotics is not recommended due to a decrease in their pharmacological effect.

For severe infections, macrolide drugs are combined with aminoglycosides, fluoroquinolones and beta-lactam antibiotics.

Antibiotics of the macrolide group are considered the safest among all groups of antibacterial drugs, but in some cases they can also cause adverse reactions from various organs and systems - allergic reactions, central nervous system disorders (headache, hearing impairment), increased activity of liver transaminases, phlebitis, nausea, diarrhea, vomiting.

Macrolides are prescribed with extreme caution for diseases of the kidneys and liver and for children with impaired conduction and excitability of the myocardium.

Source: http://bezboleznej.ru/antibiotiki-pri-gajmorite