Drugs for sinusitis in adults

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What medications should be used to treat sinusitis?

The main purpose of using drugs for sinusitis is to suppress the development of the infectious process and inflammation in the paranasal sinuses, relieve swelling of the mucous membrane, relieve pain and intoxication and prevent scarring of the tissues of the nasal sinuses.

Table of contents:

For complex therapy of this disease, you may need such effective drugs as: sinupret, sinuforte, antibiotics, vasoconstrictor drops or spray, as well as immunomodulators. These are the best medicines for quick treatment of sinusitis.

However, such drugs can only be prescribed by a specialist, because with independent or improper treatment, inflammation can become chronic or the patient risks getting one of the many complications of this disease.

Which medications for sinusitis help best?

To effectively treat sinusitis, it is necessary to use complex therapy. For this purpose, certain groups of drugs are prescribed:

  • antibacterial drugs – destruction of infection;
  • analgesics – pain reduction;
  • decongestants – removing swelling from the nasal mucosa;
  • corticosteroids – reducing inflammation in the nasal cavity;
  • mucolytics - thinning mucus and facilitating its exit from the sinuses.

The main areas of treatment include:

  • removal of inflammatory secretions and reduction of swelling in the maxillary sinuses;
  • reduction of pain and pressure;
  • destruction of infection;
  • preventing the formation of scar tissue.

Properly selected medications can quickly cure mild to moderate sinusitis, which in turn will help avoid puncture of the maxillary sinus.

Antibiotics

For mild cases of acute sinusitis, only symptomatic medications are usually prescribed. If signs of illness persist for more than five days or the person's condition worsens, then systemic antibiotic therapy will be required.

The following antibiotics are commonly used:

  1. Amoxicillin;
  2. Macrolides (azithromycin, clarithromycin, macropen);
  3. Fluoroquinolones (levofloxacin, sparfloxacin);
  4. Topical (local) antibiotics (for example, Bioparox) are prescribed for mild sinusitis as the main drug.

When choosing a drug, the sensitivity to it of microorganisms that most often cause sinusitis should be taken into account.

Vasoconstrictor drugs

They relieve swelling, thereby facilitating nasal breathing and the outflow of exudate. These drops act on the vessels located in the nasal mucosa and, by causing them to narrow, reduce the formation of mucus and tissue swelling, freeing up the nasal passages for breathing.

The best drops for the treatment of sinusitis can be considered:

  1. Preparations based on xylometazoline - galazolin, otrivin, dlyanos, tizin xylo and so on;
  2. Phenylephrine – vibrocil, adrianol;
  3. Naphazoline – sanorin;
  4. Oxymetazoline - nazole and others.

Do not forget that vasoconstrictor drops greatly dry out the nasal mucosa and can be used for no more than 5 days in a row, and they are also addictive.

Nasal rinsing

For washing, ready-made solutions are used, such as Salin, Aqua Maris, Humer, which are not drugs.

The composition of the Aqua Maris and Humer preparations includes sterile sea water, and when performing the rinsing procedure, the nasal passages are not only cleansed, but also local immunity is strengthened due to the microelements contained.

You can also rinse your nose with ordinary slightly salted water at home; this option can be used as an alternative to the above medications.

Mucolytics

Mucolytic agents (Mucodin, Fluimucil, Fluditec) actively act on mucus, reduce its viscosity, and facilitate the evacuation of secretions from the maxillary sinuses. Mucolytics are usually used in combination with antibacterial drugs and physiotherapy. Typically, these products are produced in the form of drops and syrups.

If the instructions and dosage are followed, mucolytic medications for sinusitis and sinusitis are safe and promote faster recovery.

Glucocorticoids

Can be used in the treatment of both viral and bacterial sinusitis, alone or in combination with tableted antibiotics.

Most often, these drugs are prescribed in the following cases:

  • lack of effectiveness of treatment by other methods;
  • the presence of severe swelling and inflammation;
  • the presence of polyps in the nose.

A pronounced anti-edematous and anti-inflammatory effect is especially important in patients with concomitant allergic rhinitis.

Sinuforte for sinusitis

Sinuforte is rightfully considered perhaps the most effective medicine for sinusitis presented on the modern pharmaceutical market.

The drug, made from cyclamen extract, has pronounced anti-edematous and mucolytic properties. The use of Sinuforte significantly simplifies the process of evacuating sinus secretions into the nasopharynx. Price around rub.

Sinupret

The main advantage of this drug, undoubtedly, is that it consists of herbal ingredients: elderberry flowers, gentian root, sorrel herb, verbena herb, primrose flowers. Thanks to this unique composition, Sinupret causes an antimicrobial, antiviral, and immunostimulating effect in the treatment of sinusitis.

The price of Sinupret is only 355 rubles, and the quality of the drug speaks for itself. Therefore, it has recently become the most prescribed drug for sinusitis.

Polydexa

Polydexa with phenylephrine is a spray for sinusitis, which has a pronounced antibacterial, vasoconstrictor and anti-inflammatory effect.

The therapeutic effect of the constituent components of this drug is based on their ability to block the process of protein synthesis in the cells of harmful microorganisms, thus disrupting the permeability of their cell membranes. Price 270 rub.

Other medicines

These are antipyretic and anti-inflammatory drugs (Nurofen, Ibuprofen, Paracetamol), as well as antiallergic drugs of the 2nd and 3rd generations that reduce swelling of the sinus and nasal mucosa (Loratadine, Desloratadine, Cetrin, Zinnerit, Claritin, Clarisens).

Thus, treatment of sinusitis with antibiotics is not a prerequisite for successful conservative therapy. It is much more important that the swelling is eliminated, the outflow of sinus contents is established, and local sanitation of the source of inflammation is carried out.

Good to know:

We recommend reading:

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Chronic sinusitis - symptoms and treatment in adults

Symptoms of sinusitis and treatment in adults at home

15 comments

I never thought that antibiotics would help so quickly. I caught a cold over the weekend, the cold went away, but the runny nose remained. Completely tormented me. I went to the doctor. He said it was sinusitis, prescribed procedures and prescribed Azitral. I asked if it was necessary to take antibiotics because they harm the stomach. The doctor replied that Azitral has few side effects. I took capsules once a day after lunch. The sinusitis is gone. The stomach is working normally. In general, I recommend Azitral, it helped quickly, there were no side effects.

I never thought that antibiotics would help so quickly. I caught a cold over the weekend, the cold went away, but the runny nose remained. Completely tormented me. I went to the doctor. He said it was sinusitis, prescribed procedures and prescribed Azitral. I asked if it was necessary to take antibiotics because they harm the stomach. The doctor replied that Azitral has few side effects. I took capsules once a day after lunch. The sinusitis is gone. The stomach is working normally. In general, I recommend Azitral, it helped quickly, there were no side effects.

Just don’t talk nonsense about Sinupret - this drug is not a medicine at all - it’s not even INCLUDED IN THE REGISTER OF MEDICINES! This is fucking bullshit, better than Kagocel, Anaferon and other crap.

Azitral made in India, the active ingredient is azithromycin, an analogue of azithromycin made in Russia and is cheaper, I took it, it helps well, 6 capsules in total, 1 capsule per day, it’s God’s will, whoever wants to overpay for God’s sake, take foreign medicines.

HOW TO REMOVE ACUTE BRONCHITIS IN A COUPLE OF DAYS? Let me share my experience: antibiotics are needed. Forget about all sorts of herbs, chamomile infusions, bringing down the temperature with paracetamol, etc. Only antibiotics really help, of which it is best to choose AZITRAL, it “specializes” in ENT diseases. Take AZITRAL, take it according to the instructions, and after two days you are not dying, but a full-fledged member of society. Just don’t stop taking the pills as soon as you feel better – you definitely need to complete the course.

I want to tell you how I am the grandmother of two wonderful grandchildren. They are often brought to visit me on weekends. And it happened several times that I started to get sick during the week. But you can’t, what about your grandchildren? So, as soon as I start to get sick, I immediately take Azitral. Three days and there is no trace of illness - you can babysit your grandchildren. It helps from the first tablet, so even if I got sick on Friday, on Saturday I could already spoil the children. And most importantly, there are no side effects.

Recently my wife came down with a sore throat. Naturally, I also got sick, both came down with a temperature of 39. I had an antibiotic - Azitral. And she was treated with all sorts of dietary supplements - she considers herself an advanced supporter of a healthy lifestyle. But when I was cured, after 2 days, and she became ill for the second week, she changed her mind and also took Azitral. Helped both of them out.

I have three children. I recently fell ill with some kind of acute respiratory infection. The temperature rose overnight and the cough was dry. But with children you can’t get sick, and you can get infected, and there’s no time for bed rest, because it’s always school, then kindergarten, then different clubs. I called my mother and she recommended Azitral and said she would treat herself with it. Well, without thinking twice, I bought and took the pill. By the time it was time to take care of the children, I seemed to have completely recovered. But I still finished the remaining pills. Maybe I didn’t have time to get scared, but I didn’t find any side effects.

Good day to all! I want to share my experience in treating bronchitis. I try not to joke with such things, so antibiotic therapy is my choice. Another thing is to choose the right antibiotic. My choice fell on Azitral - a cheaper analogue of Sumamed. Azitral helped perfectly - the bronchitis quickly and completely receded. Now it's your turn to share your experience!

A few years ago I went to the sea with my family. And it happened that I got sick. The pain in my throat was indescribable and my temperature rose. And I only had 10 days of vacation, and because of work I rarely saw my family, so I had no time to be sick at all. The pharmacy recommended Azitral. On the third day I was almost completely healthy and the rest was saved. Now we always carry a couple of boxes with us in case something happens.

I was sick non-stop for two months. In the mornings there was a wild pain in the throat, it was impossible to breathe, once a week I had a fever for a couple of days. I’ve even taken several courses of different antibiotics, and I’ve taken all kinds of drops and syrups, but to no avail. Either it started somewhere, or the infection is so strong. Azitral was recommended to me at the pharmacy. Believe it or not, on the fifth day, it was as if I wasn’t sick at all. No pain, no fever. I don’t use anything other than it for treatment – ​​it doesn’t let me down.

My son had bronchitis. He was treated with Azitral. The drug was given only on the 5th day. There were very strong wheezing in the lungs, the temperature was high. We did not expect that on the second day after taking Azitral the temperature did not increase. And when he drank the entire course, only minor wheezing remained. The total treatment was 3 tablets. There were no side effects, so my brother was very happy about his recovery.

I bought Azitral to treat bronchitis. I liked Azitral because it is a relatively inexpensive antibiotic. Its active ingredient is azithromycin, a broad-spectrum antibiotic. The antibiotic itself is not bad and I treat myself with it if necessary.

I have fun - I test different medications to understand which one suits me best. So I have already tried nasal drops, throat sprays, bruise ointment and a lot of other things. Of the antibiotics, for sore throat, sinusitis, bronchitis, and just a stabbing temperature, Azitral saves me, I tried so many others - there are a lot of side effects: either a headache, or aching bones, or nausea, but Azitral is a “pedantic doctor”, he cured everything, did the job functions and quietly left without a trace.

WHO IS ROLLING A CART HERE ABOUT AZITHRAL. IT'S SICK TO READ THIS IS A SIMPLE ANTIBIOTIC FROM THE GROUP OF MACROLIDES, OR MORE PRACTICALLY AZITHROMYCIN, SIMILAR TO ERYTHROMYCIN. IN ANY PHARMACY IN THE COUNTRY THEY CAN BE PURCHASED FOR A PENNY IN THE FORM OF TABLETS, SYRUPS, ETC., BOTH WITH A PRESCRIPTION OR WITHOUT (ESPECIALLY IN COMMERCIAL INDUSTRIES). ANTIBIOTICS FROM THE GROUP OF CEPHALOSPORINS OF BOTH I AND II-III GENERATIONS GIVE AN EVEN GOOD EFFECT IN ANY FORM AND ALSO FREE IN ANY PHARMACY AND FOR A PENNY. DO NOT GO FOR ADVERTISING OR A NICE NAME AND LABEL - YOU WILL JUST BE RICTED.

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Sinusitis in adults: symptoms, treatment, antibiotics. How to treat sinusitis

Sinusitis is a hidden disease, since the symptoms are very common and simple, so in the initial stages it is easy to confuse it with an ordinary acute respiratory viral infection or a runny nose.

The process of inflammation of the maxillary sinuses occurs unnoticed; the main thing is to recognize sinusitis in adults in time and begin treatment.

For this, antibiotics, folk remedies, drops, as well as nasal rinses with various solutions can be used at home. The choice of one method or another will depend on the symptoms of the disease.

Causes

The main condition under which the mucous membrane of the maxillary sinuses begins to become inflamed is a violation of their drainage.

As soon as the opening connecting the nasal passages and the cavity of the maxillary sinuses begins to narrow, the outflow of secretions from the cavities worsens. Even with slight swelling of the mucous membrane, which is observed with allergic reactions and rhinitis, drainage of the maxillary sinuses worsens and sinusitis may appear.

The main risk factors that contribute to the development of the disease:

  1. Difficulty in nasal breathing - due to enlargement of the nasal turbinates, vasomotor rhinitis, allergic diseases.
  2. Inadequate or untimely treatment of infectious, viral diseases - influenza, ARVI, tonsillitis, rhinitis.
  3. Chronic foci of infection in the nasopharynx - chronic tonsillitis, pharyngitis, rhinitis.
  4. Immune system disorders.
  5. Congenital or acquired anomalies of the nasal cavity.
  6. Allergic predisposition.
  7. Regular hypothermia.

There are three pathogens that can cause the disease:

  1. Viruses. They cause the common cold, in which the amount of mucus in the sinuses increases, thereby causing inflammation - a bacterial component can be added to it.
  2. Bacteria. There are several types of these microorganisms that are causative agents of sinusitis. These are Staphylococcus aureus, anaerobes, streptococci, pneumococci, as well as Moraxella catarrhalis and Haemophilus influenzae.
  3. Fungi. They cause disease in people with a weakened immune system, as well as those with diseases such as AIDS, leukemia, and diabetes.

As a rule, the symptoms of the disease are pronounced in the acute course of sinusitis and are hardly noticeable in the chronic form of the disease.

First signs

The main signs of acute sinusitis in adults:

  • severe runny nose with copious discharge of mucus and pus;
  • breathing problems;
  • persistent, severe headaches;
  • increasing pain in the bridge of the nose, especially radiating to the head when bending over;
  • radiating pain to the eyes, teeth, forehead area;
  • constant weakness throughout the body;
  • chills, high temperature.

Without proper treatment of sinusitis in an adult, the symptoms of the disease can develop into a chronic form.

Symptoms of sinusitis in adults

With acute sinusitis, symptoms in adults arise suddenly, together with other signs of a cold - pain in the forehead, cheeks under the eyes, nasal congestion, which does not go away within a week. As a rule, acute sinusitis does not last more than a month.

We list the symptoms that are characteristic of sinusitis:

  1. Unpleasant sensations increase in the nasal area, which are accompanied by a headache. The pain is less in the morning and becomes stronger in the evening.
  2. Severe nasal congestion, sometimes with short periods of relief. Difficulty breathing and nasal voice.
  3. Yellow-green nasal discharge when blowing nose. If the outflow from the sinus is obstructed, then such a symptom may be absent.
  4. Decreased appetite and poor sleep, despite being very tired.
  5. Increased body temperature - appears in almost all cases of sinusitis.
  6. Weakness, drowsiness, loss of appetite are signs of intoxication. There may also be nausea. Vomiting is not typical. If you have a headache and vomiting that is not related to food, and before that a copious amount of snot came out of your nose, immediately seek medical help: this can be a rather dangerous complication of sinusitis - meningitis.

When the first signs of inflammation of the maxillary sinuses are detected, it is necessary to contact an otolaryngologist and begin treatment, since only timely therapy can destroy all links in the chain that causes the inflammatory process.

Symptoms of chronic sinusitis

Without treatment, acute sinusitis can often become chronic, when the symptoms of the disease become less pronounced and erased. Chronic sinusitis in adults can be suspected if the following symptoms are present:

  1. Decreased or complete loss of sense of smell.
  2. Constant nasal congestion.
  3. Headache on one side (with a history of acute sinusitis on this side one or more times).
  4. Soreness, dryness, sore throat when swallowing - these complaints are caused by chronic inflammation of the nasopharyngeal mucosa.
  5. Periodic pain in the infraorbital region. They are dull in nature and are rarely accompanied by fever and intoxication.
  6. Fatigue, decreased memory combined with decreased sense of smell.
  7. Cough for no apparent reason: This may be the only symptom. A cough occurs due to the fact that the pharynx is irritated by mucus constantly flowing from the sinuses.

With an exacerbation of the chronic stage against the background of colds, symptoms characteristic of acute sinusitis appear - headache, pain in the sinuses when tilting the head, increased body temperature.

The nature of snot in sinusitis

Currently, there are three main shades of snot that appear against the background of the development of sinusitis:

  1. Green snot indicates a strong inflammatory process in the maxillary sinuses.
  2. If green snot develops a yellow tint, we can confidently say that sinusitis is in the acute form of the disease and requires urgent intervention from specialists
  3. The appearance of white snot is observed at the initial stage of development of sinusitis.

At each stage of sinusitis, the color of the snot changes, thanks to which specialists, when carrying out diagnostic measures, can accurately determine the phase of the disease and prescribe correct and effective treatment.

Diagnostics

In order to determine whether the patient has sinusitis, the ENT examines the nasal cavity using a rhinoscope. After this, he is sent for an x-ray, which will show whether there is an accumulation of fluid or purulent secretion inside the paranasal cavities.

In severe cases, the patient may be referred for tomography, which allows one to evaluate pathological changes in the sinuses. To study the causative agents of sinusitis, a puncture may be performed.

Complications

Untimely or inadequate treatment of sinusitis leads to complications, the main of which are:

  • abscess of the eyelid;
  • phlegmon of the orbital tissue (leads to blindness);
  • otitis;
  • pneumonia;
  • brain abscess;
  • rhinogenic sepsis;
  • bronchitis;
  • inflammation of the meninges - rhinogenic meningitis;
  • diseases of the kidneys (pyelonephritis) and heart (myocarditis).

Treatment of sinusitis in adults

When symptoms of sinusitis are detected in adults, treatment can be carried out in two main ways, depending on the severity of the condition - this is a conservative and surgical method.

  1. With the conservative method, the patient takes an antibiotic and other general and local drugs.
  2. As for the surgical method, it is assumed that a puncture of the maxillary sinus will be performed.

Conservative therapy for sinusitis includes:

  1. Use of antibiotics.
  2. Local antibacterial therapy (drops, sprays, inhalations are used to eliminate swelling of the mucous membrane).
  3. Anti-inflammatory therapy.
  4. Rinsing the nose with antiseptics, for example, furatsilin.
  5. The use of physiotherapy (ultraviolet irradiation of the nasal cavity, exposure to a high-frequency magnetic field on the paranasal sinuses, etc.).

Treatment of sinusitis is aimed at:

  • elimination of swelling of the nasal mucosa;
  • timely evacuation of the contents of the maxillary sinuses;
  • relieving the inflammatory process;
  • normalization of nasal breathing;
  • preventing the development of dangerous consequences.

Medicines are selected taking into account the cause of the disease. These can be antibiotics, antivirals, vasoconstrictors, antihistamines.

What antibiotics to take for sinusitis in adults

Antibiotics treat sinusitis caused by bacteria and fungi. The viral form cannot be cured with antibiotics. However, viral sinusitis is often complicated by bacterial infections. The doctor, based on the patient’s condition, can immediately prescribe a broad-spectrum antibiotic even before the results of bacterial culture of nasal discharge.

In adults, preference is given to the following drugs:

  1. Amoxicillin. This antibiotic belongs to the penicillin group. If the patient has malignant blood tumors, is lactation, or is pregnant, this drug should not be prescribed.
  2. Macropen. This antibiotic has a very strong bactericidal effect and actively fights a variety of intracellular microorganisms. When taking it, a slight allergic reaction may occur, which is manifested by intestinal upset. It is not prescribed during pregnancy.
  3. Flemoxin solutab. An antibiotic from the penicillin group that fights aerobic bacteria.

The use of local antibiotics for sinusitis must be combined with the use of vasoconstrictor drops. For example, the drug Otrivin. Otherwise, the effect of treatment will be minimal. In the chronic form of the disease, the same drugs are prescribed, but for a longer period of time.

Surgery

Surgical treatment is started if conservative methods are ineffective. To remove contents from the maxillary sinus, a puncture is performed; based on the results of the examination of the discharge, further treatment is prescribed.

Fungi may be detected in the washing liquid; in this case, antibiotics are discontinued and antifungal treatment is prescribed. If anaerobic bacteria are detected, treatment of the sinuses with oxygen is prescribed.

Nasal rinsing

As a result of nasal rinsing at home:

  • swelling decreases;
  • breathing becomes easier;
  • inflammation is extinguished;
  • the protective properties of the nasal cavity are strengthened.

For rinsing, you can use not only furatsilin solution and salt water, but also infusions of herbs such as calendula, chamomile, eucalyptus and others. All of them have remarkable anti-inflammatory effects.

Treatment without puncture

  1. The main method is rinsing the nose using the “Cuckoo” apparatus. Over the course of 5-7 sessions, the nasal passages are cleansed of mucus and pus.
  2. Laser heating. As a rule, it complements rinsing procedures. The laser can relieve inflammation, destroy pathogenic microbes, and reduce swelling.
  3. The use of devices that create negative pressure in the maxillary sinuses, which has a beneficial effect on cleansing the nose.

How to treat sinusitis at home

You can get rid of illness by combining drug treatment and folk remedies. How to treat this disease at home? Here are popular recipes.

  1. The juice of Kalanchoe and aloe is actively used for sinusitis. The juice of the plant is mixed in equal proportions with vegetable oil, after which the resulting mixture is inserted with tampons into the nostrils. Relief comes quite quickly.
  2. Beets have a very strong antibacterial effect. By instilling a couple of drops of freshly squeezed beet juice into each nostril 4 times a day, you can get rid of sinusitis quickly and for a long time. Before starting the procedure, to get the best effect, you should rinse your nose thoroughly with saline. In case of a strong burning sensation, the juice can be slightly diluted with saline solution.
  3. Chop one fourth of the onion and place in a gauze bag. Use it to massage the area of ​​the bridge of the nose and nose. Repeat several times a day. They promise that the maxillary sinuses will be cleared of purulent contents in 10 days when using this simple recipe.

However, folk recipes cannot be considered as full-fledged therapy. They can only be used as an addition to the main course of treatment, only after prior agreement with the otolaryngologist.

Source: http://03-med.info/lor/gaymorit-u-vzroslykh-simptomy-lechenie.html

Treatment of sinusitis in adults

Sinusitis is the name given to acute or chronic inflammation of the mucous membrane of the maxillary, or maxillary, paranasal sinuses. This disease affects people of any age, but in children under 5 years of age it is extremely rare, since their paranasal sinuses are underdeveloped.

What are the maxillary sinuses

The maxillary paranasal, or maxillary, sinuses are air cavities with a volume of about 12–13 cubic meters. cm, located in the body of the upper jaw on both sides of the nose. Each sinus is lined from the inside with a mucous membrane in which the choroid plexuses, nerve endings and mucous glands are located; it opens into the nasal cavity with a separate opening, or anastomosis.

The functions of the maxillary sinuses, like other sinuses, are to warm and humidify the air entering the body through the nose, as well as to clean it.

Causes and mechanisms of sinusitis

Inflammation of the maxillary sinus can be caused by a bacterial, viral, fungal infection, or be of an allergic nature.

In case of swelling of the anastomosis connecting the maxillary sinus with the nasal cavity, the outflow of mucus from the sinus is disrupted, creating an ideal environment for the proliferation of the pathogen, and therefore for the development of the inflammatory process.

The following may contribute to the development of the disease:

  • hypothermia;
  • anatomical features of the structure of the nose (deviated nasal septum);
  • bad habits (mainly smoking);
  • decreased immune status of the body;
  • concomitant somatic pathology (cystic fibrosis);
  • foci of chronic infection in the body (chronic rhinitis, tonsillitis, caries);
  • lifestyle features (hobby for scuba diving).

Sinusitis is characterized by seasonality, with 2 peaks of incidence:

  • February – March (seasonal ARVI period);
  • August – September (rest on reservoirs, acclimatization, use of air conditioning).

Classification of sinusitis

  1. Acute (illness duration up to 4 weeks):
    • edematous or catarrhal form;
    • purulent form;
    • form with a severe, aggressive course (necrotic).
  2. Chronic (4 weeks after the onset of the disease):
    • purulent form;
    • polypous form;
    • purulent-polypous, or mixed, form

Symptoms of sinusitis in adults

The following patient complaints are typical for acute sinusitis:

  • increase in body temperature to subfebrile (no more than 38 C) numbers;
  • fever;
  • general weakness, weakness;
  • prolonged runny nose (discharge is mucous, mucopurulent or purulent);
  • nasal congestion;
  • deterioration of sense of smell;
  • when discharge from the nose flows down the back wall of the pharynx into the larynx (this happens especially at night and in the morning) - cough;
  • with purulent sinusitis – putrid odor of discharge;
  • on the side of the affected sinus – pain in the area of ​​the bridge of the nose and brow ridges, aggravated by coughing and sneezing, tilting the head down;
  • feeling of pressure in the sinuses and nose;
  • swelling of the soft tissues under the eyes (in the area of ​​the lower eyelid), in the projection of the affected sinus, is possible.

The clinical manifestations of chronic sinusitis are more smoothed out. Patients are concerned about:

  • moderate general weakness;
  • fatigue, more during intellectual work;
  • mild headache without clear localization;
  • feeling of heaviness in the head;
  • nasal congestion;
  • deterioration of sense of smell;
  • soreness, dryness, sore throat when swallowing - these complaints are caused by chronic inflammation of the nasopharyngeal mucosa (chronic nasopharyngitis), caused by the irritating effect of mucous or mucopurulent masses flowing from the inflamed sinus;
  • swelling of the lower eyelid in the morning, conjunctivitis - indicate involvement of the orbital wall in the pathological process.

Allergic and vasomotor rhinitis are characterized by an undulating course, with alternating periods of remissions and exacerbations.

Complications of sinusitis

Untimely or inadequate treatment of sinusitis in 5–8% of cases leads to complications, the main of which are:

  • inflammation of the meninges - rhinogenic meningitis;
  • brain abscess;
  • rhinogenic sepsis;
  • abscess of the eyelid;
  • phlegmon of the orbital tissue (leads to blindness);
  • otitis;
  • pneumonia;
  • bronchitis;
  • diseases of the kidneys (pyelonephritis) and heart (myocarditis).

Diagnosis of acute and chronic sinusitis

In most cases, the diagnosis of sinusitis does not cause difficulties for a specialist.

A general practitioner or ENT doctor will be able to suspect sinusitis based on the patient’s complaints, medical history and life history. In order to visually assess the condition of the nasal mucosa, the doctor will perform a rhinoscopy, with the help of which he will see swelling, hyperemia of the mucous membrane, and purulent discharge from the sinuses.

In order to clarify the diagnosis, the patient may be prescribed one or more additional research methods:

  • rhinoendoscopy of the nasal cavity and paranasal sinuses;
  • radiography of the maxillary sinuses;
  • puncture of the maxillary sinus;
  • bacteriological examination of material taken from the sinuses;
  • allergy tests;
  • immunogram.

How is sinusitis treated in adults?

Treatment of sinusitis, both acute and chronic, should be started in a timely manner and include all the necessary groups of drugs. In no case should you self-medicate - the patient should be under the supervision of a doctor throughout the entire course of treatment. As a rule, treatment is outpatient, but in some cases the doctor may insist on hospitalization of the patient in the ENT department.

Drug treatment of acute sinusitis in adults may include:

  • if pus is not detected on an x-ray of the maxillary sinuses, but there is only swelling of the mucous membrane, it means that the nature of the disease in this case is viral - antiviral drugs are prescribed (Groprinosin, Ingavirin, Amizon);
  • if the x-ray of the sinuses clearly shows the presence of pus in them, and also in the absence of effect from the previous adequate treatment of the catarrhal form of the disease, sinusitis in adults is treated with antibiotics (broad-spectrum antibacterial drugs of various groups are used: cephalosporins (Cefix, Ceftriaxone), aminopenicillins (Amoxiclav), respiratory fluoroquinolones (Levofloxacin, Moxifloxacin);
  • A high concentration of an antibacterial drug can be achieved directly at the site of inflammation by using local antibiotics in the form of sprays; the most prominent representative of drugs in this group is Bioparox;
  • to restore air exchange between the inflamed sinus and the nasal cavity, vasoconstrictor drops and sprays are used (Otrivin, Nazivin, Sanorin);
  • the combined drug Rinofluimucil will help relieve swelling from the mucous membrane of the nose and maxillary sinuses, as well as improve the rheological properties of sputum;
  • if the patient is worried about a high temperature (above 38.5–39 C), antipyretics are indicated (based on ibuprofen (Nurofen, Imet), paracetamol (Panadol, Solpadein); drugs in this group will also reduce pain and have a mild anti-inflammatory effect; it is worth It should be noted that they should not be taken at a temperature in courses, but strictly according to indications - they are not effective for preventive purposes.

When signs of inflammation decrease, i.e. when the acute stage of the disease transitions to subacute, further treatment should be carried out using physiotherapy:

  • UHF on the maxillary sinuses;
  • solux;
  • magnetic therapy on the pharynx area;
  • laser therapy.

The course of treatment for any physiotherapy performed is about 10–12 sessions.

The key to successful treatment of chronic sinusitis in adults is the elimination of factors that contribute to chronic inflammation in the maxillary sinus: chronic diseases of the ENT organs of other localizations, adenoids, caries, deviated nasal septum and others. Drug therapy for exacerbation of chronic sinusitis should include:

  • vasoconstrictor drugs (Nazivin, Nazol, Otrivin) in short courses;
  • washing the paranasal sinuses with disinfectant solutions, followed by the introduction of antibacterial drugs and proteolytic enzymes into the cavity;
  • immunity correctors (after preliminary consultation with an immunologist);
  • in case of allergic nature of sinusitis - antihistamines (Cetrin, Telfast, Erius) and hormone-containing sprays (Avamys).

Physiotherapeutic treatment methods are also used:

  • Ultrasound of the maxillary sinuses;
  • UHF to the area of ​​the maxillary sinuses;
  • magnetic therapy on the pharynx area;
  • electrophoresis of enzymes (lidase) or iodine on the sinuses;
  • ultraphonophoresis with cortisone;
  • infrared laser therapy;
  • speleotherapy (a type of climatotherapy using the microclimate of salt caves).

In some cases, with severe forms of sinusitis, a drainage puncture is performed to restore the patency of the sinus anastomosis. This procedure also makes it possible to remove pus from the sinus within a short time and introduce antibacterial drugs into the area of ​​inflammation.

In certain forms of chronic sinusitis (necrotic, purulent polyposis), conservative treatment is often ineffective. In this case, the patient is recommended to undergo surgery – maxillary sinusotomy.

Prevention of sinusitis

To prevent the development of sinusitis, you should:

  • maintain free passage of the nasal passages (timely correction of the nasal septum, reduction of hypertrophied turbinates, removal of nasal polyps);
  • healthy lifestyle (good nutrition, adherence to work and rest schedule, regular physical activity);
  • frequent exposure to fresh air;
  • timely adequate treatment of colds;
  • sanitation of foci of chronic infection in the body.

Forecast

The prognosis for adequate and timely treatment of acute sinusitis is favorable - in the vast majority of cases, complete recovery is noted.

It is almost impossible to get rid of chronic sinusitis, but you can only put the disease into stable remission (in the case of a significant decrease in immunity, chronic sinusitis will most likely “wake up” again).

Source: http://otolaryngologist.ru/232

Review of remedies for the treatment of sinusitis

The treatment of sinusitis must be approached seriously and individually, because with inadequate therapy, this disease can become chronic or cause the development of severe complications: loss of vision, meningitis or sepsis. Today, the pharmacological market offers many highly effective drugs that can help the patient quickly cope with the disease and get rid of the symptoms that bother him: headache, high fever and constant nasal congestion.

The action of drugs for sinusitis is aimed at eliminating the causes and symptoms of the disease:

  • destruction of the pathogenic microorganism that caused inflammation of the maxillary sinuses;
  • elimination of swelling and drainage of purulent contents from the sinuses;
  • elimination of inflammation;
  • anesthesia;
  • prevention of the formation of scars or scars on the mucous membrane.

Groups of drugs for the treatment of sinusitis

Treatment of sinusitis is always complex, and the group of medications needed by the patient is selected individually, depending on the severity of the symptoms. The drug therapy regimen may include the following groups of drugs:

  1. Antibiotics – to fight infection.
  2. Adrenergic agonists - to eliminate swelling of the nasal mucosa and drainage of purulent contents.
  3. Medicinal solutions for rinsing the nasal cavity.
  4. Corticosteroids - to eliminate inflammatory foci.
  5. Analgesics – for pain relief.
  6. Mucolytics - for better drainage of purulent contents from the sinuses.
  7. Antihistamines - to reduce swelling of the mucous membrane.
  8. Herbal preparations (Sinuforte, Cinnabsin, Sinupret).

Antibiotics

Antibacterial agents are used to treat sinusitis, which was caused by bacterial pathogenic flora (staphylococci, fusobacteria, streptococci, corynebacteria, etc.). When selecting a drug, the doctor takes into account the type of bacteria that led to the development of the inflammatory process and the standards of treatment protocols. Depending on the active substance, the patient may be prescribed antibacterial drugs from the following groups:

  • macrolides: Azithromycin, Macropen, Midecamycin, Erythromycin, Klacid, Clarithromycin;
  • cephalosporins: Cefodox, Cefazolin, Ceftriaxone, Cefataxime;
  • fluoroquinolones: Ofloxacin, Levofloxacin, Moxifloxacin;
  • penicillins: Amoxicillin, beta-lactams with clavulanic acid (Amoxiclav, Flemoclav, Solutab, Augmentin), Ampicillin, etc.

In some cases, patients with sinusitis are prescribed antibiotics from the groups of levomycins, aminoglycosides or tetracyclines.

In case of severe sinusitis, the patient may be prescribed antibiotics for intramuscular or intravenous administration (Meropenem, Tobramycin, Ceftriaxone, etc.), and in milder forms - capsules, tablets or syrups.

Antibacterial drugs for the treatment of sinusitis are divided into three lines:

  • I – have maximum effectiveness and are used primarily, these include: Azithromycin, Amoxicillin;
  • II - used to treat patients who live in areas with a high level of resistance of microorganisms, or in the absence of effect from the use of drugs from the first line, these include: Amoxicillin with clavulanic acid, fluorocholines and cephalosporins of II and III generations;
  • III – used for inhalation treatment of the maxillary sinuses in patients after surgical treatment of sinusitis and in patients for whom the use of first and second line antibiotics is undesirable or contraindicated, these include: Fluimicil-antibiotic IT, Thiamphenicol glycinate acetylcysteinate.

After starting the use of antibiotics, relief of the patient's condition occurs in the first days of treatment. The duration of taking drugs for the systemic treatment of sinusitis in its acute course is about 5-7 days, in chronic cases - 2-3 weeks.

Also, drops and sprays containing antibiotics can be prescribed for antibacterial treatment of sinusitis. In some cases, their use can relieve the patient from taking systemic antibiotics. Most often, patients with sinusitis are prescribed the following antimicrobial drops:

  • Polydexa - this complex drug has antimicrobial, anti-inflammatory and vasoconstrictor effects, can be used alone or as part of complex therapy, is used to treat children starting from 2.5 years old, the drug contains: neomycin sulfate, phenylephrine, polymyxin B sulfate and dexamethasone;
  • Bioparox (Fuzofungin) - the active component of the drug is fusafungin, which has antibacterial and anti-inflammatory activity and can be prescribed to children over 2.5 years of age;
  • Isofra, the active component of the drug framycetin, has a pronounced antimicrobial effect, can be used as part of complex therapy for sinusitis and can be used to treat children over one year old.

Isofra

Antibiotics for the treatment of sinusitis may not be used in the following cases:

  1. For mild sinusitis.
  2. With the development of inflammation of the maxillary sinuses due to an allergic reaction.
  3. In case of chronic sinusitis and the presence of a concomitant fungal infection.

Adrenergic agonists

Adrenergic agonists are used to relieve nasal congestion, facilitate the release of purulent contents from the maxillary sinuses and reduce swelling of the nasal mucosa. To treat sinusitis, they are used in combination with antibacterial, anti-inflammatory and other agents.

The most popular drugs from this group are the following drugs:

  • Oxymetazoline (Nazivin, Nazol, Nazol Advance) - the active component of this drug is oxymetazoline hydrochloride, its effect begins to appear minutes after use and continues for 12 hours, can be used to treat children over 6 years of age;
  • Galazolin (drops, gel) - the active component of this drug is the alpha-adrenergic agonist xylometazoline hydrochloride, its action begins 5-10 minutes after administration and continues when using drops for 5 hours, gel - about 10 hours, the drug in the form of 0.05 % drops can be prescribed to children over 2 years old, 0.1% - over 6 years old, 0.05% gel - over 3 years old, 0.1% gel - over 12 years old;
  • Sanorin - the active component of this drug is the alpha-adrenergic agonist naphazoline nitrate, can be used for the treatment of sinusitis in the form of a 0.05% solution in children over 2 years old, in the form of a 0.1% solution in children over 15 years old.

Sanorin

After using these drops, gels or sprays, it is recommended to instill drops with antibiotics within minutes - this way, a better effect of the drugs is achieved and the effectiveness of the use of antibacterial external agents is not reduced.

Main contraindications of adrenergic agonists:

  • individual intolerance to the components of the drug;
  • erosive and ulcerative diseases of the gastrointestinal tract;
  • diseases of the cardiovascular system;
  • diabetes;
  • pregnancy and lactation;
  • age restrictions.

Medicinal solutions for rinsing the nasal cavity

To treat sinusitis, various hypertonic, isotonic, hypotonic and antiseptic solutions are often used, which are used in the form of irrigation and rinsing. Such procedures help:

  • reducing swelling of the nasal mucosa;
  • mechanical cleansing of clots of purulent secretion;
  • moisturizing the nasal mucosa;
  • improving the functioning of the cilia of the mucociliary apparatus;
  • elimination of inflammatory foci.

The following drugs can be used to perform them:

  • antiseptics: solutions of Miramistin, Furacillin, Chlorhexidine, Dioxidine;
  • Dolphin powder (for preparing the solution);
  • nasal sprays based on sea salt for irrigating the nose: Marimer, AquaMaris, Salin, Humer, Aqualor, etc.;
  • hypo-, iso- and hypertonic solutions with the addition of propolis tincture, calendula, etc.

The effectiveness of nasal lavages for the treatment of sinusitis and other sinusitis is recommended by the world's leading otolaryngologists and is actively used to treat adults and children of any age.

Corticosteroids

Drugs from the group of corticosteroids can significantly alleviate the condition of patients with viral, bacterial or allergic sinusitis. They have a pronounced anti-inflammatory effect and help restore the body's immune forces. The main indications for prescribing corticosteroids are:

  • pronounced inflammatory focus and swelling of the nasal mucosa;
  • lack of effect from the use of other medications;
  • the presence of polyps in the nasal cavity.

The most popular corticosteroid drugs for the treatment of sinusitis are:

  • Nasonex - the active component of the drug is mometasone furoate, which has a pronounced anti-inflammatory and antiallergic effect, when applied topically does not have a systemic effect on the body, Fluticasone

can be used to treat children over 2 years of age;

The dosage of corticosteroids and the duration of their use can only be determined by a qualified ENT doctor, who can take into account the severity of sinusitis and the characteristics of the patient’s health condition.

Analgesics

The use of analgesics for sinusitis helps improve the general condition of the patient and eliminate headaches and fever. For this purpose, non-narcotic analgesics can be used, which also have a pronounced anti-inflammatory effect on the nasal mucosa. Most often prescribed for these purposes:

The duration of taking these medications should not last more than 7 days, and before using them, you should consult your doctor about the safety of their use. Analgesics are prescribed with caution to patients with gastrointestinal ulcers, allergic reactions and asthma.

Mucolytics

The prolonged course of the inflammatory process in the maxillary sinuses leads to an increase in the viscosity of nasal secretions. To liquefy it, it is extremely important to use mucolytic agents that help liquefy thick pus and mucous secretions:

  • Fluimucil (tablets, solution) - the active component of the drug is acetylcysteine, which promotes the rupture of intra- and intermolecular disulfide bonds of mucopolysaccharides of sputum and leads to a decrease in the viscosity of sputum, the drug is also capable of providing antioxidant and anti-inflammatory effects, can be used to treat children of any age category (for children under 6 years of age are recommended to use only the tablet form, and the solution can only be used in a hospital setting);
  • Rinofluimucil (spray) - the drug is a combination drug, its active ingredients are acetylcysteine ​​and tuaminoheptane sulfate, which have mucolytic, vasoconstrictor and antioxidant effects, the drug can be used for children of any age, but children under 3 years of age are prescribed with caution.
  • Fluditec (Mukosol, Fluifort, Mucodin) - the active component of the drug is carbocysteine, which helps to liquefy sputum and purulent contents of the nasal sinuses, restores the secretion of immunoglobulin IgA, the drug is available in the form of syrup and can be used to treat children over 2 years of age.

Antihistamines

For sinusitis, antihistamines are used to reduce swelling of the nasal mucosa. For this, the patient is prescribed drugs of group II or III, which have a less depressing effect on the central nervous system:

  • Loratadine (Lorano, Claritin, Lorfast, etc.);
  • Sequifenadine;
  • Fenistil;
  • Fenkarol;
  • Cetrin (Aleron, Cetirizine, Zodak, Zirtec, etc.);
  • Desloratadine (Eden, Erius, Fribris);
  • Fexofenadine (Telfast, Tigofast, Allergo, Altiva);
  • Levocetirizine (Aleron, L-Cet, Xyzal).

Herbal preparations

For the treatment of acute and chronic sinusitis, combination drugs based on natural components that can affect the symptoms of the disease are successfully used. The most famous among them:

  • Cinnabsin (tablets) is a homeopathic drug that helps eliminate headaches, swelling of the mucous membrane, difficulty in nasal breathing, inflammatory foci and trigeminal neuralgia, the components included in the drug reduce the viscosity of secretions and have an immunomodulatory effect on the body, can be used to treat children;
  • Sinuforte (nasal aerosol) - a drug based on lyophilized juice and extract of European cyclamen tubers is able to act on the receptors of the trigeminal nerve and cause in minutes a reflex increase in secretion in the mucous membrane, hypersecretion leads to dilution and an increase in the volume of inflammatory exudate, which facilitate the evacuation of secretions from the maxillary cavities, also the drug has anti-inflammatory and vasoconstrictor effects and can be used to treat children over 5 years of age;
  • Sinupret (dragées, drops for oral administration) - the composition of this plant-based drug includes powders of primrose, elderberry, gentian, sorrel and verbena, thanks to their properties it is able to have a mucolytic, secretomotor, anti-inflammatory, decongestant and immunomodulatory effect, can be used in the form tablets for the treatment of children over 2 years old, in the form of drops – over 6 years old.

Which doctor should I contact?

If you have sinusitis, you need to seek help from a therapist or ENT doctor. If necessary, a consultation with an allergist and physiotherapist will be scheduled. In severe cases of sinusitis, treatment by an oral and maxillofacial surgeon may be necessary.

Dr. Komarovsky talks about the treatment of sinusitis in children:

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