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What is the treatment for sinusitis?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am a 69-year-old male and retired internist. Other than vitamins and prostate-related herbs, I take no medication. I have no allergies and have never smoked. My past medical or surgical history is rather unremarkable. I have had several bouts of acute sinusitis in years past. Four weeks ago, my wife and I developed URTI. My illness had a sinus component featuring marked nasal and sinus congestion, postnasal drip, upper airway congestion and cough productive of clear sputum. I assumed the etiology was viral and treated it as such. After two weeks of little improvement, I assumed a bacterial etiology and initiated Augmentin 875 mg bid. After five days with little improvement, I switched to Cipro 500 mg bid. After four days, I saw my primary care doctor who prescribed Azithromycin 500 mg per day. Following the second day of treatment, I developed severe fatigue, generalized weakness, and headache, which forced me to discontinue the Azithromycin. I then decided to wait until the Zithromax cleared my system before re-evaluating. After some eight days, I developed a purulent nasal discharge for which I again saw my primary care MD who prescribed Doxycycline 100 mg bid. Note that I requested a culture and sensitivity of the purulent discharge but was rebuffed. After 24 hours on Doxycycline, I felt greatly improved with little sinus pressure or congestion and minimal, clear nasal discharge. Now, on day four of Doxycycline, I have noted some return of the sinus pressure, post-nasal drip, and nasal congestion. However, the mucus is clear. I was given a steroid nasal spray which only served to increase the mucosal irritation of my sinuses, nasal passages, throat, and upper airways. I was never febrile at any point. I am exceedingly frustrated. Note that in the past I used Levaquin and developed marked insomnia and very lucid dreams when I was able to sleep. Please help.

Answered by Dr. Anshul Varshney

Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

This doctor is not available for online consultations on the platform anymore.

Hi,

Welcome to icliniq.com.

We are here to help you.

You are suffering from chronic sinusitis. And I feel this is all allergic and you do not need antibiotics. Usually, an acute attack takes five days to settle down. But, if you have persisting sinusitis, you would require CT paranasal sinuses. If the CT shows slight sinus infection, then it can be treated with conservative treatment. But, if the infection is severe, you would require surgery for the same.

The conservative management of sinusitis includes the following:

  1. Steam inhalation four to six times a day.
  2. To take antiallergic like Levocetirizine.
  3. In cases, who do not respond to antiallergic drugs can opt for Fluticasone nasal spray.
  4. Short course of antibiotics like Amoxicillin and Clarithromycin will help.
  5. Please share my opinion with your doctor before acting upon it. I hope it helps.

Medically reviewed by iCliniq medical review team
Published At March 26, 2016
Reviewed At February 9, 2024

Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

This doctor is not available for online consultations on the platform anymore.

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Companion

Sinusitis Treatment Companion

How it works

Sinusitis can be frustrating, especially when symptoms linger. This section helps you understand the condition, its common treatments, and when to seek further medical advice.

1

Sinusitis
Basics

2

Symptoms
Causes

3

Conservative
Care

4

Antibiotics
Sinusitis

5

Nasal
Sprays

6

Specialist
Care

Important Note on Medications

Medications should be taken after consulting a physician. The dosages will be prescribed by the physician. Do not alter, start, or stop medications without consulting a healthcare professional.

This information is based on general medical guidance. It is not a substitute for professional medical advice; consult a qualified clinician.

Always consult a doctor before taking medication; self-medication carries serious health risks. Take exact prescribed doses, and never start, change, or stop treatment without medical supervision.

Education:

MBBS

Professional Bio:

Dr. Anshul Varshney is a highly skilled Critical Care Physician specializing in nephrology, pulmonology, and rheumatology. He is committed to providing advanced, life-saving care to critically ill patients while addressing complex medical conditions affecting the kidneys, lungs, and immune system. His holistic and multidisciplinary approach ensures comprehensive treatment tailored to individual patient needs.

This doctor is not available for online consultations on the platform anymore.

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