1. Sinusitis (Sinus Infection) Slideshow Pictures
2. Nasal Allergy Relief Products Slideshow Pictures
3. 10 Common Allergy Triggers Slideshow Pictures

Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Steven Doerr, MD

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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The chief goal of treatment is eliminating bacteria from the sinus cavities with antibiotics. This helps to prevent complications, relieve symptoms, and reduce the risk of chronic sinusitis.

• For acute, uncomplicated cases, a synthetic penicillin like amoxicillin (Amoxil, Polymox, or Trimox) is used most commonly. This antibiotic is effective against the usual causative microorganisms and is relatively inexpensive. Amoxicillin's main side effects include allergic reactions (throat swelling, hives) and stomach upset.
• People allergic to penicillin can take a sulfur-containing antibiotic called trimethoprim/sulfamethoxazole or TMP/SMX (Bactrim, Cotrim, or Septra). Sulfa drugs ares not recommended for people who are allergic to sulfur.
• People who have several episodes of partially treated acute sinusitis or those who have chronic sinusitis may become resistant to amoxicillin and TMP/SMX. Newer synthetic penicillins and cephalosporins such as amoxicillin/clavulanate (Augmentin), cefuroxime (Ceftin), and loracarbef (Lorabid) can clear most of the resistant organisms that cause sinus infection.
• Overuse of these "broad-spectrum" antibiotics may eventually lead to organisms evolving that can resist even the most potent antibiotics currently available. Simpler antibiotics such as amoxicillin should be used first and taken for the entire duration (14-21 days). The basic rule of thumb is to take the antibiotic until the symptoms disappear, and then continue to take the antibiotic for one more week.

To treat acute sinusitis, one or more OTC or prescription therapies may be all that is necessary. For those with recurrent bouts of acute sinusitis or chronic sinusitis, the addition of intranasal or oral steroids (prednisone) may reduce symptoms. Commonly prescribed medications are beclomethasone (Beconase, Vancenase), fluticasone (Flonase), triamcinolone (Nasacort), and flunisolide (Nasalide).

• Steroids are potent inhibitors of inflammation.
• Nasal sprays (intranasal steroids) work directly on the lining of the nasal passages and sinuses with little effect on the rest of the body when taken in prescribed dosages.
• As with the other classes of drugs, many intranasal steroids are available. Some are more tolerable than others. These are prescription medications. These drugs do not relieve symptoms immediately like nasal and oral decongestants do, but once therapeutic drug levels are achieved, symptoms usually improve, and decongestants may be unnecessary.
• During months when environmental allergens are most widespread, the early administration of intranasal steroids may help keep the sinuses open and draining, and prevent sinusitis.

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