Effective antibiotics for sinusitis

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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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Antibiotics for sinusitis. Which drug to choose for a serious sinus disease?

Sinusitis is a type of acute sinusitis - inflammation of the paranasal sinuses. With sinusitis, the large maxillary sinuses, called the maxillary sinuses, are affected. The English physician Highmore first described the symptoms of acute sinusitis back in the 15th century and retained his name in history.

Before you continue reading: If you are looking for an effective method of getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to look at this section of the site after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

The name of the disease, noticed by an Englishman more than 500 years ago, is heard, alas, too often. About 1 in 10 adults experiences sinusitis. In pediatrics, inflammation of the maxillary sinuses is a common complication of a respiratory viral infection: 6–13% of acute respiratory viral infections result in bacterial infection and sinusitis.

According to statistics published by American experts, about 14% of adults experience at least one episode of acute sinusitis per year. And let’s complete our immersion in the world of numbers with information from the field of pharmaceuticals. Sinusitis occupies an honorable fifth place among diagnoses for which antibiotics are prescribed.

The target is pathogenic bacteria!

So, we have already figured out that sinusitis is an inflammatory process. This means that it is caused by pathogenic microorganisms. In healthy people, the maxillary sinuses are sterile. However, as a result of obstruction of the drainage paths, disruption of the activity of the ciliated epithelium and changes in the quality and quantity of mucus, the maxillary sinuses are colonized by pathogenic bacteria. The main causative agents of the inflammatory process in the maxillary sinuses include:

  • Staphylococci, including S.pyogenes, S.aureus (Staphylococcus aureus), S.pneumonia, coagulase-negative staphylococcus;
  • streptococci, including alpha-hemolytic streptococcus;
  • fusobacteria;
  • Moraxella;
  • corynebacteria;
  • peptostreptococci;
  • Haemophilus influenzae.

I would like to note that in approximately 30% of cases of sinusitis, the infection is of mixed origin, that is, the number of pathogens is more than one.

Any inflammatory process accompanied by bacterial infection requires antibacterial therapy. No matter how much we would like, the body is not able to cope with the onslaught of pathogenic microorganisms on its own, and antibiotics are essential drugs for sinusitis.

Let's try to figure out what antibacterial drugs are prescribed for inflammation of the maxillary sinuses and when one or another drug is preferred.

What antibiotics should I take for sinusitis? General selection principles

When choosing an antibacterial agent, doctors, as a rule, are guided by general principles that are regulated in standard treatment protocols.

And acute sinusitis is no exception. What antibiotics are taken for sinusitis? Antibacterial agents prescribed for acute sinusitis are divided into three large groups.

First line drugs.

This category includes drugs that are used primarily. It is these antibiotics that have maximum effectiveness for sinusitis and are used for treatment as the drugs of choice:

Second line drugs.

These agents are used to treat patients who live in environments with high rates of resistant microorganisms. In addition, reserve group drugs are used if first-line antibiotics do not give the desired result after 3–7 days of treatment for sinusitis. Second-line antibiotics include:

  • Amoxicillin with clavulanic acid;
  • cephalosporin antibiotics of the second and third generation;
  • fluoroquinolones.

Patients with hospital-acquired sinusitis are a special category of patients whose treatment will require intravenous administration of antibacterial drugs. Among the most effective injection drugs we note:

To understand the specifics of using antibiotics for sinusitis, you will have to consider each drug in more detail. And we will start with the most popular antibacterial agent of the penicillin series - Amoxicillin.

Are penicillins the enemies of sinusitis?

Penicillins are deservedly among the most effective and safe antibacterial agents. They can be prescribed to children, from infancy, to adults and elderly patients.

In addition, penicillins are widely used in obstetrics. Drugs of the benzylpenicillin group belong to category B, conditionally permitted during pregnancy and lactation. The experience of prescribing these drugs in pregnant women proves the high safety and excellent tolerability of the drugs. Penicillins are the drugs of choice for many infectious diseases in pregnant women.

However, we must not forget that many strains of pathogens produce beta-lactamases, which destroy the beta-lactam ring of the antibiotic. The danger of prescribing penicillins for acute sinusitis is due to the fact that among the causative agents of the disease there are strains that produce beta-lactamases. That is, when treating sinusitis with unprotected antibiotics of the penicillin group, there is a hypothetical probability of the drug being ineffective.

Does Amoxicillin help with sinusitis?

The effect of Amoxicillin, one of the most famous antibiotics from the group of semisynthetic penicillins, for sinusitis was studied by American scientists. The randomized, placebo-controlled trial included 166 adults with acute bacterial sinusitis. Of this group, 85 lucky people received Amoxicillin, and 81 people received a placebo. The course of treatment was 10 days. Who do you think is luckier?

The results of the experiment were quite unexpected. On the third day of therapy, there was no difference in well-being between the two parallel groups. On the seventh day of the study, volunteers taking antibiotics reported feeling better. These data were confirmed laboratory. However, the story did not end there.

On the tenth day of the experiment, 80% of patients from both groups reported a significant improvement in their health or complete recovery. The results of a study on the comparative effectiveness of the antibacterial agent Amoxicillin and placebo in the treatment of sinusitis showed that the effect of unprotected penicillin is practically no different from the effect of a pacifier.

When prescribing Amoxicillin, one should not forget that about 64% of S.pneumoniae staphylococcus strains are resistant to penicillin. And Staphylococcus aureus is “famous” for its resistance to unprotected antibiotics of this group, reaching 90% and above. According to American scientists, the resistance of Haemophilus influenzae to Amoxicillin ranges from 27–43%.

And yet, despite all this very contradictory information, Amoxicillin (or Flemoxin) until recently was used to treat uncomplicated forms of sinusitis as the antibiotic of choice, especially for children. Moreover, the drug was recommended as one of the three first-line antibiotics, that is, those drugs that are prescribed first.

Let us recall that the activity of Amoxicillin extends to strains of streptococcus pneumoniae, Haemophilus influenzae and anaerobic bacteria. The drug has a moderate effect on moraxella and is not effective against infection with bacteria that produce beta-lactamase.

According to information published by American scientists, the effectiveness of treatment of sinusitis with high doses of Amoxicillin is 80–90%. The high safety of penicillin antibiotics allows Amoxicillin to be widely used for sinusitis in children.

Dosages of Amoxicillin for uncomplicated sinusitis are quite impressive and are almost twice as high as the standard dose. Experts recommend prescribing about 80–90 mg of Amoxicillin per kilogram of body weight per day. The daily dose must be divided into two doses. It is better to take the drug after meals. The duration of treatment is usually 5–7 days.

Macrolides - antibiotics for sinusitis No. 1

The antibiotics of choice for the treatment of sinusitis include drugs from the macrolide group. Macrolides do not contain a lactam ring, so the notorious penicillinase is absolutely powerless in relation to these drugs. This means that macrolides also effectively act on strains of microorganisms that produce beta-lactamases.

Macrolides, compared to penicillins, exhibit much greater activity against the bacterium Moraxella catarrhalis (Moraxella).

I would like to add that macrolides are the drugs of choice for allergies to penicillin antibiotics.

Among the drugs that most widely cover the spectrum of potential pathogens of acute sinusitis, Clarithromycin and Azithromycin are recognized as the most effective and safe. Let's try to understand the advantages and disadvantages of each of these antibiotics.

This drug belongs to the second generation macrolides and has high activity against all microorganisms, without exception, associated with acute and chronic sinusitis.

For sinusitis, 500 mg to 750 mg of Clarithromycin are prescribed twice a day, and the pediatric dosage of the antibiotic is 7.5 mg per kilogram of body weight per day. It is better to use the medicine at regular intervals.

The course of treatment is from 7 to 10 days. The final decision on the dosage and duration of therapy is made by the attending physician.

Azithromycin is a 15-membered macrolide. The main difference between an antibiotic and other drugs is its long half-life. Thanks to this property, Azithromycin has a completely unique course of treatment.

For the treatment of sinusitis in adults, Azithromycin is used in a dosage of 500 mg once on the first day of therapy, after which it is sufficient to drink 250 mg of the antibiotic once a day for four days. Thus, the course of treatment for acute sinusitis is only five days.

Second-line antibiotics: complicated and purulent sinusitis

As we have already mentioned, second-line drugs are prescribed if the causative agents of sinusitis are resistant to Amoxicillin and macrolides. In this case, it is recommended to culture the material to determine sensitivity to antibiotics, but empirical prescription of drugs is also allowed.

When can a doctor suspect a resistant infection and what symptoms indicate high resistance of pathogenic microorganisms?

Infection with resistant strains of bacteria is likely if the patient does not feel improvement within the first two to three days of first-line antibiotic therapy. That is, if after three days of taking Amoxicillin or Clarithromycin you still have symptoms of intoxication - fever, weakness and headache - you must immediately notify your doctor. Most likely you will have to select an alternative antibiotic.

Second-line antibacterial drugs that are indicated for the treatment of sinusitis include protected penicillins, cephalosporins and fluoroquinolones. Let's take a closer look at these groups.

Protect Amoxicillin!

We have already said that a particular problem in selecting an antibiotic for the treatment of sinusitis is the presence of beta-lactamase-producing strains among the causative agents of the disease. Therefore, the ideal treatment for acute sinusitis includes a procedure such as sowing the contents of the maxillary sinuses and determining sensitivity to antibiotics. This test allows you to identify the pathogen and select an antibacterial agent that is active against the microorganism.

However, not everything is as simple as it seems. After all, to obtain the material it is necessary to perform a puncture, and this is a very serious procedure. Therefore, doctors, as a rule, have to act almost at random, and treatment is prescribed empirically. The doctor’s main task at this stage is to select exactly the antibiotic that will work. In the vast majority of cases, ENT doctors avoid prescribing Amoxicillin and go straight to second-line drugs.

Unprotected penicillins are being replaced by complexes with clavulanic acid. They have all the advantages of Amoxicillin and do not have its main disadvantage - vulnerability to penicillinase.

The most popular protected penicillins, which are often used for sinusitis, include tablets Augmentin, Amoxiclav, Flemoklav and other antibacterial drugs. Experts say that Amoxicillin and clavulanic acid complexes are effective in more than 90% of cases of sinusitis.

For sinusitis, it is recommended to take protected Amoxicillin twice a day. The final dosage and course of treatment is determined by the attending physician.

Cephalosporin antibiotics in tablets: alternative help for sinusitis

For sinusitis, second- and third-generation antibiotics from the group of cephalosporins are used as second-line tablets. These include oral forms:

Cefuroxime is a second generation cephalosporin. Cefuroxime tablets are produced:

  • the German company Sandoz called Cefuroxime-Sandoz;
  • Glaxo Corporation (Zinnat);
  • Medokemi company (Cyprus) produces antibiotic tablets Aksef.

Cefuroxime has a pronounced effect on the vast majority of pathogens of acute sinusitis, including strains that produce beta-lactamase. The standard dosage is 250 mg cefuroxime twice daily for 7–10 days.

Cefpodoxime is a third generation cephalosporin. The main difference between these antibiotics and second-generation drugs is their high activity against gram-negative flora. In addition, injectable drugs of this group have very high bioavailability, while oral drugs, on the contrary, are poorly absorbed in the intestine.

One of the most common drugs containing cefpodoxime is Jordanian Cefodox, which is available in the form of tablets of 100 and 200 mg, as well as a children's suspension in several dosages. In addition, Indian Cepodem is registered in Russia. Note that most doctors prefer to prescribe the Jordanian analogue.

Cefodox has a fairly low level of absorption - only about 52%. Therefore, when prescribing this tablet antibiotic for sinusitis, the doctor must take into account the low bioavailability of the drug.

The dosage of cefpodoxime for acute sinusitis is 200 mg twice daily for 7–10 days.

The drug also belongs to the third generation semisynthetic cephalosporins. I would like to draw your attention to the fact that Cefixime is inactive against many gram-positive bacteria. Thus, most strains of Staphylococcus aureus are resistant to this antibiotic.

Just like Cefpodoxime, Cefixime is poorly absorbed from the gastrointestinal tract: the bioavailability of the drug is only 40-50%.

As a common analogue of Cefixime, we will name the antibiotic Suprax, which is also available in a dispersible form, which has higher bioavailability. In addition, in Russian pharmacies you can find the Indian analogue Ixim and the medicine produced in Macedonia Pancef.

American experts recommend not using third-generation cephalosporins as monotherapy for the treatment of sinusitis due to the fairly high probability of bacterial resistance to these antibiotics. The combination of Cefixime and Cefpodoxime is capable of covering almost the entire spectrum of pathogenic bacteria associated with sinusitis.

Thus, one of the most effective alternatives to protected penicillins is the use of two cephalosporins at once - Cefpodoxime and Cefixime.

According to experts, the effectiveness of these antibiotics for acute purulent sinusitis is more than 90%.

Well-known and effective fluoroquinolone antibacterial drugs that are used to treat acute and chronic sinusitis include:

Note that fluoroquinolones are contraindicated for use in children and adolescents. This is associated with the risk of developing irreversible changes in the structure of cartilage tissue. However, for health reasons, fluoroquinolones are still used in childhood.

When are antibiotic injections used for sinusitis?

We have come to a description of one of the most pressing problems faced by patients suffering from acute sinusitis. The fact is that domestic ENT doctors, in their undoubtedly noble desire to quickly relieve the patient of the symptoms of sinusitis, vying with each other to prescribe injectable drugs.

Doctors eloquently convince their patients of the urgent need for parenteral treatment as the only possible path to healing. Exhausted by the lack of a breath of fresh air, patients, of course, believe the all-powerful man in a white coat and obediently follow to the pharmacy for a set of syringes, bottles of antibiotics and lidocaine.

This is followed by seven or even ten days of procedures, and then treatment of the consequences of injection therapy. Of course, after such therapy the disease recedes. However, are antibiotic injections really necessary for sinusitis?

According to leading experts in the field of otorhinolaryngology, parenteral use of antibiotics is indicated for patients with hospital-acquired acute sinusitis. In such cases, the infection is usually caused by highly resistant gram-negative microorganisms. The drugs of choice include aminoglycoside antibiotics. To correctly select an antibacterial agent, it is recommended to inoculate the culture and determine the sensitivity of the inoculated bacteria.

Let us consider the dosages and spectrum of activity of parenteral antibiotics in more detail.

The most effective drugs include Tobramycin and Gentamicin. It is worth noting that both antibiotics are not active against streptococci and other anaerobic bacteria. Moraxella and Haemophilus influenzae, on the contrary, are highly sensitive to the action of aminoglycosides.

The dosage of Tobramycin and Gentamicin is calculated depending on the patient’s weight: per kilogram of weight there is 1.7 mg of antibiotic. Frequency of application: twice a day.

It is worth noting that the use of aminoglycosides is associated with a high risk of side effects. One of the most dangerous adverse events associated with treatment with these drugs is damage to the auditory branches, resulting in irreversible deafness. Therefore, Tobramycin and Gentamicin are used exclusively under the supervision of a physician.

Second generation cephalosporins.

Cefuroxime is practically the only second-generation parenteral cephalosporin antibiotic used for the treatment of acute sinusitis. Injectable medicines containing cefuroxime as an active ingredient are lyophilized powder that must be diluted before use. The most commonly used solvents are water for injection and 2% lidocaine solution.

To treat sinusitis, 1 gram of Cefuroxime is prescribed every eight hours. One of the most famous drugs in Russia containing cefuroxime is Zinacef.

Third generation cephalosporins.

Injectable agents in this group include Cefotaxime, Ceftazidime and, of course, the well-known Ceftriaxone. Third generation cephalosporins are highly active against gram-negative microorganisms.

The recommended dosage of antibiotics for the treatment of severe sinusitis is:

  • Cefotaxime is prescribed 2 grams every 4–6 hours;
  • Ceftriaxone - 2 grams per day, divided into two doses;
  • Ceftazidime is used at a dose of 2 grams every 8 hours.

Severe cases of acute purulent nosocomial sinusitis require the use of potent broad-spectrum antibiotics - carbapenems. These drugs are used exclusively in a hospital under the supervision of specialists.

Antibiotic drops for sinusitis: necessary or useless?

Many patients ask the same question: do antibiotic nasal drops and sprays help with sinusitis? Is it worth using them? And is it possible to get by with local remedies without resorting to oral, that is, tablet drugs? It's time to clear all doubts.

If you are diagnosed with sinusitis, you need to be prepared for the fact that it is almost impossible to cure without antibiotics - a bacterial infection simply requires adequate therapy. Local preparations - sprays and nasal drops - containing an antibacterial active substance are not able to penetrate the maxillary sinuses. Consequently, their use is practically meaningless. So, let us emphasize: for acute and chronic sinusitis, nasal drops or antibiotic sprays are simply ineffective.

The only way out in this situation is oral, and in severe cases, parenteral (injection) antibacterial agents.

Prescribing antibiotics is the doctor’s task

I would like to draw your attention to the fact that the selection of the correct antibacterial drug is the prerogative of the ENT doctor. We must not forget that among the causative agents of acute sinusitis there are also antibiotic-resistant strains that are insensitive to penicillins and cephalosporins. Therefore, self-prescription of an antibiotic for sinusitis may result in serious complications rather than the desired recovery.

Remember that at the first signs of sinusitis you need urgent consultation with a specialist and immediate antibacterial treatment.

The article above and comments written by readers are for informational purposes only and do not encourage self-medication. Consult a specialist regarding your own symptoms and illnesses. When taking any medicine, you should always use the instructions that come with the medicine and your doctor's advice as a guide.

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Antibiotic for sinusitis in adults - names of drugs. Treatment of sinusitis in adults with antibiotics

As part of an integrated approach to the treatment of inflammation of the paranasal sinuses, specific medications are used. So, bacterial sinusitis requires the prescription of antibiotics. Familiarize yourself with the main representatives of this group of medications.

Antibiotics for sinusitis

With the help of specific laboratory tests of a smear taken from the patient’s nose, the causative agent of the disease and its sensitivity to certain antimicrobial agents are determined. Antibiotics for sinusitis are prescribed only if the patient has a fever, purulent discharge, or pain. For mild inflammation, doctors usually recommend inhalations, rinsing, and nasal drops. It is important to note that the antibiotic for adults is also selected taking into account the individual characteristics of the body. For the most part, for sinusitis the following is prescribed:

  1. Penicillins - have minor side effects;
  2. Macrolides - prescribed for intolerance to the former;
  3. Fluoroquinols are broad-spectrum drugs;
  4. Cephalosporins - used when other drugs are ineffective.

Drops for sinusitis

Patients often choose intranasal administration of antibacterial agents instead of oral administration. For this purpose, patients are prescribed special drops. Products for topical use are indicated for persons suffering from dysbacteriosis, liver or kidney pathologies. Among the most effective antibiotics for sinusitis in adults in the form of drops are:

  • Garazon – the active ingredient of the drug is gentamicin. Garazon is intended for the treatment of inflammation of the ears and eyes, but can be used as nasal drops for sinusitis.
  • Sofradex is a complex drug that includes framycetin, gramicidin C and dexamethasone. Sofradex is effective against otitis externa, but can be used as nasal drops.

Tablets for sinusitis

Only a specialist can select effective antibiotic pills. Tablets for sinusitis are prescribed only during the acute phase of the disease. Therapy for the chronic form of the disease comes down to the use of local remedies. It is important to note that the latest generation antimicrobial tablets do not inhibit the natural intestinal microflora. The following antibiotics are effective for sinusitis in adults:

  • Flemoxin Solutab - the maximum concentration of the drug in the blood is achieved 2 hours after taking it. Flemoxin has almost no effect on the gastrointestinal tract.
  • Clarithromycin is a relatively cheap tablet. They act on intra- and extracellular bacteria.
  • Sumamed is an antibiotic with unique pharmacokinetics. Fights against a large number of foreign agents. A separate advantage of Sumamed can be considered a short course of treatment (only 5 days).
  • Avelox is a broad-spectrum medicine. An antibiotic is prescribed when other drugs are ineffective.

Spray for sinusitis

Mild inflammation can be relieved with local antibacterial agents. In this regard, a spray for sinusitis is a good solution to the problem of nasal congestion and other symptoms of the disease. It is important to note that intranasal antibiotics avoid many of the side effects associated with oral medications. Effective sprays for sinusitis are:

  • Isofra - the medicine is evenly distributed, its particles are able to penetrate even the most inaccessible places. The course lasts no more than a week, the dosage is selected individually.
  • Polydexa with phenylephrine - spray has antibacterial and vasoconstrictor effects. Relieves swelling from mucous membranes. Duration of treatment is about 7 days.

Injections for sinusitis

For severe inflammatory processes, doctors usually prescribe injectable antibiotics. Injections for sinusitis are allowed to be given for no more than a week. In exceptional cases, the course may be extended for a few more days. Such therapeutic measures are used if the patient has good tolerance to the drug. As a rule, the following is administered by injection:

  • Amoxiclav (amoxiclav) – has a bactericidal effect. The drug is active against a wide range of pathogens. Amoxilav should be injected in high doses.
  • Cefazolin has a pronounced antimicrobial effect. The concentration of Cefazolin in the blood is maintained for 12 hours.

How to choose an antibiotic for sinusitis in adults

Antimicrobial agents are prescribed taking into account the sensitivity of the pathogens found in the smear to certain drugs, so the course of treatment is selected purely individually. Regarding the question of which antibiotic is better for sinusitis in an adult, it is worth saying that doctors in most cases prescribe a medication with fewer side effects. At the same time, the effectiveness of the drug must also be taken into account.

Price for antibiotics for sinusitis in adults

The cost of antimicrobial agents by pharmacies is often inflated. However, do not try to buy medicines from a catalog in an online store. As practice shows, such sites offer products without certificates of conformity. You can order the inexpensive medications you need from specialized virtual pharmacies. Prices for antibiotics for sinusitis in adults are shown in the table below:

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Find out more about the drug amoxicillin - dosage for adults and children, instructions for use, contraindications.

Video: medications for sinusitis in adults

Reviews

I have been treating inflammation for six months. At first I was confused about what antibiotics to take for sinusitis in adults, but after a detailed story from the attending physician, I understood everything. I can say with confidence that only Tsiprolet helps me during exacerbations. A very inexpensive medicine with a minimum of side effects.

My acute rhinosinusitis resolved within a week from the start of treatment with Isofra. I didn’t seem to feel any negative aspects. I paid, as I remember, no more than 200 rubles for the spray. After several nasal injections, the pain in the sinuses went away, and after 5 days heavy purulent discharge began to come out of the nose.

One doctor friend constantly recommended taking antibiotics for ENT diseases in adults. I had chronic rhinitis, which threatened to turn into inflammation. For this reason, I started injecting Polydex with phenylephrine into my nose. The entire treatment took no more than a week. The drug turned out to be, admittedly, very effective.

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Source: http://sovets.net/8245-antibiotik-pri-gaymorite-vzroslyim.html

What antibiotics are prescribed for sinusitis or a review of the best drugs

The main signs of sinusitis are nasal congestion, headaches and a possible increase in body temperature. The disease can occur in acute or chronic form. In the acute form, a person recovers from the disease and forgets about it. However, chronic sinusitis periodically reminds itself.

Pus and mucus stagnate in the nasal sinuses, which is why a person develops a headache that gets worse when bending over. Moreover, the stronger it is, the more serious the stage of the disease. Although pain can be a sign of other diseases.

With sinusitis, the nasal cavity becomes inflamed, swollen and swollen. The channels between the nasal passages and the inflamed sinuses become blocked. As a result, the mucus does not come out of the filled cavities and turns into pus, which puts pressure on the walls of the sinuses. However, often with sinusitis there is mucous discharge from the nose, but the sinuses are not completely freed from mucus.

Patients try to get rid of unpleasant symptoms with the help of antipyretics, nasal drops and nasal rinses, as well as analgesics.

Symptomatic treatment should be combined with antibacterial treatment. Treatment with antibiotics is necessary for both acute and chronic sinusitis. Antibiotics are especially important for purulent sinusitis.

Classification of antibiotics used for sinusitis

Modern medicine offers a large selection of drugs to eliminate the cause of the inflammatory process in the sinuses. All antibacterial drugs according to their mechanism of action are divided into:

  1. Bactericidal. They destroy bacteria and provoke their death.
  2. Bacteriostatic drugs. Prevent pathogenic microorganisms from growing and developing. However, the bacterial cells themselves remain alive and are eliminated by the patient’s immune system.

What antibiotics to take for severe sinusitis should be decided by the attending physician. After all, the characteristics of the patient’s body and the course of the disease are always individual. Antibiotics often lead to complications if used incorrectly.

Depending on the form of release and method of use, antibiotics against sinusitis are divided into two groups. The first of them is local. They are used to treat the nasal passages - these are ointments and solutions for rinsing the nose. The second group is system tools. These products are used in the form of injections or tablets, as well as capsules.

In this case, systemic drugs are almost always used. Local antibiotics for the treatment of sinusitis in adults and children are just an addition to them. Sprays, antibiotic nasal drops or solutions for rinsing the paranasal sinuses may be prescribed as the main treatment only for mild forms of the disease.

From the point of view of the main active ingredient, antibiotics that treat purulent sinusitis are also divided into several types. Each group affects a specific bacterial spectrum. Let's list them:

Antibacterial drugs of the penicillin series

Their main effect is bactericidal. Moreover, they destroy various types of pathogenic microorganisms. Therefore, penicillins are widely used to treat inflammatory processes.

However, there are bacteria that destroy penicillins. Therefore, pharmacists developed protected medications. In addition to penicillin, they contain clavulanic acid.

Unpleasant consequences of treatment with such drugs are rare. However, the wrong dosage of an antibiotic is fraught with side effects from the gastrointestinal tract. Allergic rhinitis and other manifestations of individual intolerance are also possible.

Most often, penicillin antibiotics for bacterial sinusitis are taken in tablet form. However, for the treatment of children, medicine offers penicillin suspensions. Their taste is improved with fruit fillers. Let's list which antibiotics for annoying sinusitis are penicillin:

Cephalosporins

If a patient requires treatment of chronic sinusitis with antibiotics, the doctor may prescribe cephalosporins. Their chemical structure is similar to penicillin, but they are more resistant to penicillin-resistant microorganisms.

Experts identify five generations of such drugs. Each generation of cephalosporins has a specific structure and spectrum of therapeutic action. The first, second and third generation drugs are effective against sinusitis:

For severe forms of sinusitis, these antibiotics are used both intravenously and intramuscularly (solution) and orally (tablets). However, if the medicine belongs to the group of cephalosporins, people with allergies should treat this drug with caution. Cephalosporins and penicillins are related groups of drugs, so intolerance to one group means a similar reaction to the other.

Azalides and macrolides

These are bacteriostatic drugs that act on chlamydia and mycoplasma. This means that they stop the development of intracellular pathogens of acute sinusitis. The best modern antibiotics for sinusitis for allergy sufferers, since they are not related to the two previous groups. Therefore, if cephalosporins for sinusitis cannot be prescribed to you, azalides are an excellent solution.

Azalides and macrolides for sinusitis are good because they only need to be used once every day. Moreover, short courses of treatment with similar antibiotics can be periodically carried out - chronic sinusitis requires just such a solution.

Representatives of this group of drugs include:

These drugs are available in various forms. These can be capsules, tablets and even powders.

Aminoglycosides

They destroy mainly gram-negative bacteria, although they are also effective against other types of microorganisms. However, this group of drugs is used exclusively in severe cases. Aminoglycoside therapy is characterized by an increased risk of side effects.

However, an otolaryngologist prescribes aminoglycosides for sinusitis if other means do not help. Systemic antibiotics for colds (sinusitis) are reserve drugs. But local remedies are allowed. The list of aminoglycosides for topical use for sinusitis includes Isofra and Polydexa. The first representative of this group of semisynthetic drugs contains framycetin, and the second contains neomycin.

Fusafungins

They perfectly speed up the healing process of a sick person due to their anti-inflammatory effect. Fusafungin is a topical antibiotic. A well-known drug with this active ingredient is Bioparox, which is available in the form of an aerosol. They treat the nose, as well as the ears and throat, if necessary.

Equipped with a special dispenser and nozzles. An effective antibiotic for incipient sinusitis. However, in severe cases of the disease, it is better to use it in combination with systemic agents.

Fluoroquinolones

Included in the list of effective antibiotics for bacterial sinusitis. Destroy pathogens. Represented by several generations of drugs. Sinusitis is treated with the first two. Known fluoroquinolones:

For purulent sinusitis, these antibiotics are very helpful. However, they need to be treated under the guidance of a doctor. May have local or systemic effects.

Lincosamides

Bacteriostatic and bactericidal agents. Excellent antibiotics for acute sinusitis, although they also help with chronic ones. But this is still a backup option for treating sinusitis. Well-known representatives are Dalatsin and Clindamycin.

Polymyxin therapy

Polymyxins are included in the list of specific antibiotics for sinusitis. Destroy Pseudomonas aeruginosa. Not applied systematically. Polymyxin "B" is one of the components of Polydex nasal spray.

Sulfonamides

They have an antibacterial effect. Widely known in the treatment of diseases of the ENT organs. Popular representatives today are Streptocide and Sulfamide.

Such antibiotics can cure sinusitis. However, doctors prefer more modern drugs to avoid side effects.

Tetracyclines

Effective against a huge number of bacteria. However, they are less effective than penicillins if the pathogen is a gram-positive microorganism. Therefore, they rarely treat sinusitis. For sinusitis, tetracycline tablets are used only for sinusitis in adults.

Features of antibiotic treatment for children and adults

It is better to treat preschoolers with penicillin drugs. Powders and medicinal suspensions are especially good. The most effective antibiotics for childhood sinusitis are Augmentin and Amoxiclav.

The doctor must determine which antibiotic is best for persistent sinusitis for a child. However, in children the disease is more often caused by mycoplasma and chlamydia. Penicillins do not cope with them. In such cases, the antibiotic Fromilid uno (suspension) is best tolerated by children for sinusitis. Other azalides and macrolides are also good.

As in children and adults, the selection of antibacterial therapy is carried out individually by the attending physician.

The problem is that the causative agent is often not identified. Then doctors choose which antibiotic can be taken for sinusitis in adult patients empirically. These are usually broad-spectrum antibiotics. Their list includes:

  • Azitrox and other azithromycin derivatives;
  • Amoxiclav;
  • Lincomycin;
  • Ceftriaxone.

To prescribe specific and, importantly, sensitive therapy, microbiological examination of the discharge of the paranasal sinuses should be carried out. In cases where the causative agent of sinusitis is confirmed by bacteriological examination, the antibiotic is chosen specifically taking into account the sensitivity of microorganisms. Let's list what antibiotics are taken for sinusitis with a known pathogen:

When a doctor decides which antibiotics a particular patient needs for sinusitis, he takes into account his individual characteristics. The age of the patient, the presence of contraindications, and possible side effects are important. The characteristics of the course of the disease are also taken into account.

In addition, this is how the duration of therapy is determined. Sometimes it is enough to take an antibiotic for only 3 days for mild sinusitis. However, in other cases, treatment takes a week or even several weeks.

Mistakes in treating sinusitis with antibiotics

Despite the widespread practice of using antibiotics for chronic sinusitis or acute forms of the disease, people often misunderstand their properties and make mistakes when using this group of drugs. What are these mistakes? Let's look at the most common myths and misconceptions:

  1. Antibiotics reduce fever. This is wrong! They fight pathogens of infectious diseases. As a result, the body destroys the remaining bacteria. After this, body temperature normalizes. Doctors do not treat sinusitis with any antibiotics in adults and children without control. Otherwise, patients risk serious complications.
  2. Antibiotics fight viruses. Again, signs of a cold, nasal congestion, general weakness and headache belong to the clinical picture of sinusitis of any nature. But for successful treatment it is necessary to understand the etiology of the disease. If the illness is caused by a virus, you should not think that any antibiotic will help. You need to use antiviral agents.
  3. Antibiotics will prevent sinusitis. Yes, antimicrobials can indeed prevent infection in some cases. They also make surgery safer. It also helps people with immune deficiency. However, if a person takes strong antibiotics to prevent sinusitis, this will not help him.
  4. A remedy that helps friends is a panacea. This is an erroneous judgment. Only a doctor can tell you which antibiotic a particular person should take for sinusitis. Firstly, the nature of sinusitis can be different. Secondly, there are allergies and idiosyncrasies - intolerance reactions. Don’t ask what antibiotic your friend took for sinusitis - it’s better to go to the doctor.
  5. Treatment of sinusitis with antibiotics at home can be carried out without a doctor’s recommendation. An otolaryngologist will tell you which antibiotic is effective for sinusitis. You cannot self-medicate so as not to provoke complications.
  6. Cheap antibiotics do not help with severe sinusitis. In fact, an effective antibiotic for bacterial sinusitis is determined individually. Sometimes inexpensive antibiotics for complicated sinusitis work better than expensive ones.

Important rules for using antibiotics for sinusitis

It is important to take antibiotics for acute sinusitis in adults and children, subject to certain rules. They provide improvement in the patient's condition. Doctors advise:

  1. Be sure to read the instructions accompanying each drug: the name of the antibiotic, dosage for adults and children for sinusitis.
  2. Treatment should be aimed at the cause, not the symptoms. Also remember: take whatever antibiotics the doctor prescribes for the patient. It's better not to experiment with analogues.
  3. Sinusitis and strong antibiotics are compatible only with the bacterial form of the disease. If your illness is caused by a virus, you will be prescribed antiviral drugs.
  4. The use of tablets must be careful: antibiotics used for sinusitis cause complications. This happens when they are used incorrectly.
  5. Only a doctor will select the most effective antibiotic for any sinusitis. He will also determine the dosage, frequency and duration of taking the drug.
  6. Taking local antibiotics for ongoing sinusitis must be combined with systemic antibiotics. Nasal antibiotics are not enough for sinusitis.
  7. It is important to begin treating rhinitis before it develops into sinusitis.

conclusions

When faced with unpleasant symptoms, ask your doctor which antibiotic should be used to treat sinusitis. 3 out of 4 people will prefer self-medication, but this is a mistake. You cannot be guided only by what antibiotics your friends take for sinusitis.

Modern medicine offers a huge selection of drugs. Adults understand that the name of an antibiotic for sore throat and sinusitis partially indicates its composition. But you still need to read the instructions.

It is easier to treat sinusitis in adults than in children - no matter what antibiotics the doctor uses, they are usually suitable for an adult patient, but children have restrictions on some medications. Therefore, treating a child is a more responsible undertaking.

Antibiotics used for sinusitis should be used with an understanding of their indications and contraindications. It is customary to read the instructions before taking an antibiotic or other medicine for sinusitis for the first time. The most effective medications for bacterial sinusitis are narrowly targeted antibiotics, although this remedy cannot always be used. After all, the causative agent of inflammation is often unknown.

Source: http://gaimorit.guru/preparations/antibiotiki-pri-gajmorite