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Is cephalexin good for sinus infections: Cephalexin in the treatment of acute and chronic maxillary sinusitis

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Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

A bacterial infection is caused by an opportunistic overgrowth of bacterial organisms in the body’s tissue or organs. A common condition known as “strep throat” is actually an overgrowth of the bacteria streptococcus pyogenes, sometimes referred to as group A streptococcus, in the throat or on the tonsils. Earaches may be caused by bacteria in the inner or outer ear, and they may lead to fluid buildup and pressure. A toothache could be an abscess of bacteria below the gums. Bacterial infections come in many forms.

Antibiotics are the pinnacle of treatment against bacterial infections. The first antibiotic discovered was penicillin, and it belongs to a group of antibiotics known as beta-lactam antibiotics. Beta-lactams attack the cell wall of bacteria, rendering the bacteria powerless and allowing the body to resolve the infection. Since the discovery of penicillin, there have been many classes and types of beta-lactam antibiotics developed. Cephalexin and amoxicillin are two commonly used beta-lactam antibiotics.

What are the main differences between cephalexin and amoxicillin?

Cephalexin is a prescription medication used to treat a variety of bacterial infections. It is a first-generation cephalosporin antibiotic, which belongs under the larger classification of beta-lactam antibiotics. Cephalexin interferes with cell wall synthesis by binding penicillin-binding proteins inside the cellular wall. Ultimately, when cephalexin is dosed appropriately, it causes lysis, or destruction, or the bacterial cell. Different bacterial types contain different bacterial binding proteins, so the effectiveness of cephalexin varies with different types of bacteria.

Cephalexin is available as an oral tablet or capsule, as well as an oral suspension. The brand name of cephalexin is Keflex. It is used by infants, children, and adults.

Amoxicillin is a prescription medication also used to treat a variety of bacterial infections. It is a penicillin antibiotic but also falls under the larger classification of beta-lactam antibiotics. Amoxicillin, like cephalexin, interferes with cell wall synthesis by binding penicillin-binding proteins inside the cellular wall leading the destruction of the bacterial cell.

Amoxicillin is available as an oral tablet or capsule, chewable tablet, as well as an oral suspension. The brand name of amoxicillin is Amoxil or Polymox. It is used by infants, children, and adults.

RELATED: Cephalexin details | Amoxicillin details

Main differences between cephalexin and amoxicillin
Drug class Cephalosporin/ Beta-lactam antibiotic Penicillin/ Beta-lactam antibiotic
Brand/generic status Brand and generic available Brand and generic available
What is the brand name? Keflex Amoxil, Polymox
What form(s) does the drug come in? Tablet, capsule, suspension Tablet, capsule, chewable tablet, suspension
What is the standard dosage? 500 mg four times daily 500 mg two to three times daily
How long is the typical treatment? 7-14 days 7-14 days
Who typically uses the medication? Infants, children, adults Infants, children, adults

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Conditions treated by cephalexin and amoxicillin

Cephalexin has been shown to be active against a variety of bacterial organisms including Escherichia coli, Haemophilus influenzae (beta-lactamase negative), Klebsiella pneumoniae, Moraxella catarrhalis, Proteus mirabilis, Staphylococcus aureus (MSSA), Staphylococcus epidermidis, Streptococcus pneumoniae, and Streptococcus pyogenes. The sensitivity of these organisms allows cephalexin to also be effective in treating many common types of infections including upper respiratory infections such as sinusitis, pharyngitis, and tonsillitis. Amoxicillin is also effective against lower respiratory infections such as community-acquired pneumonia. Other uses of cephalexin include skin infections (cellulitis), bone and joint infections, otitis media, and urinary tract infections (UTI).

Amoxicillin has been shown to be active against a variety of bacterial organisms including Enterococcus faecalis, Escherichia coli, Haemophilus influenzae (beta-lactamase negative), Helicobacter pylori, Proteus mirabilis, Staphylococcus sp., Streptococcus agalactiae, Streptococcus pneumoniae, and Streptococcus pyogenes. The sensitivity of these organisms allows amoxicillin to also be effective in treating many common types of infections including upper and lower respiratory infections. Other uses include skin tissue infections, otitis media, and urinary tract infections.

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Both cephalexin and amoxicillin have commonly been used off-label for endocarditis prophylaxis. Patients with congenital heart defects or prosthetic heart valves are at an increased risk of developing an infection in the lining of their heart after dental procedures. Prophylactic doses of antibiotics such as amoxicillin and cephalexin given prior to these procedures have been shown to decrease the risk of such infections.

Upper respiratory infections Yes Yes
Pharyngitis Yes Yes
Tonsillitis Yes Yes
Sinusitis No Yes
Community-acquired pneumonia Yes Yes
Non-specific lower respiratory infections Yes Yes
Cellulitis Yes Yes
Impetigo Yes No
Otitis media Yes Yes
Osteomyelitis Yes No
Infectious osteoarthritis Yes No
Urinary tract infections Yes Yes
Mastitis Yes No
Bacterial endocarditis Off-label Off-label
Lyme disease No Off-label
Dental infections No Off-label
H. pylori duodenal ulcer No Off-label

Is cephalexin or amoxicillin more effective?

The effectiveness of cephalexin or amoxicillin will vary with each bacteria type and each patient. With any sensitive bacteria, each drug may be effective so long as it is dosed appropriately at the correct intervals. The effectiveness of beta-lactam antibiotics are dependent upon the amount of time that free, non-protein bound drug is above the minimum inhibitory concentration (MIC) of the bacteria.

Another factor in antibiotic therapy is antibiotic resistance. Antibiotic resistance occurs when bacteria changes in response to an exposure to an antibiotic. The change is adaptive to allow it to survive in spite of the antibiotic. In the case of beta-lactam antibiotics, the bacteria produce beta-lactamase enzymes,` which render the antibiotic ineffective. Repeated or overuse of antibiotics, as well as suboptimal dosing, may contribute to antibiotic resistance.

One study sought to compare the symptomatic relapse in pediatric patients with streptococcal tonsillopharyngitis. This was done by comparing return visits and symptomatic complaints following each type of treatment. The study compared four treatment groups including amoxicillin and first-generation cephalosporins, including cephalexin. The study found that the incidence of symptomatic relapse was higher in the amoxicillin group than in the first-generation cephalosporin group.

The Infectious Disease Society maintains in its guidelines that amoxicillin is the first choice for group A streptococcal pharyngitis. Cephalexin is an acceptable alternative for patients with a penicillin-related allergy.

Only your doctor can determine which treatment is appropriate for your bacterial infection.

Coverage and cost comparison of cephalexin vs. amoxicillin

Cephalexin is a prescription medication that is covered by both commercial and Medicare drug insurance plans. A typical prescription for cephalexin would be written for 28 capsules of the 500mg strength. The average cash price for this prescription without insurance can be close to $50 or higher. With a coupon from SingleCare, you can get it for as low as $9.

Amoxicillin is a prescription medication that is also covered by both commercial and Medicare drug insurance plans. The cash price for a prescription written for 21 capsules of the 500mg strength of amoxicillin is over $20, but with a coupon from SingleCare, you can get this prescription starting as low as $5.

Typically covered by insurance? Yes Yes
Typically covered by Medicare? Yes Yes
Standard dosage 28, 500 mg capsules 21, 500 mg capsules
Typical Medicare copay Typically less than $10, but varies by plan Typically less than $10, but varies by plan
SingleCare cost $9-$17 $5-$10

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Common side effects of cephalexin vs. amoxicillin

Cephalexin and amoxicillin have a similar list of side effects. The most common side effect of both medications is diarrhea. Other gastrointestinal side effects include nausea, vomiting, and gastritis. In rare instances, cases of pseudomembranous colitis have been reported.

Anaphylactic reactions may happen with both cephalexin and amoxicillin. Anaphylactic reactions are a severe allergic reaction that may present with hives, swelling of the tongue or lips, and/or a restrictive airway. Anaphylactic reactions require immediate medical attention.

The following list is not intended to be a complete list of possible side effects. Please consult a pharmacist, doctor, or another medical professional for a complete list of possible side effects.

Side effect Applicable? Frequency Applicable? Frequency
Diarrhea Yes Not defined Yes Not defined
Dyspepsia Yes Not defined Yes Not defined
Gastritis Yes Not defined Yes Not defined
Abdominal pain Yes Not defined Yes Not defined
Nausea Yes Not defined Yes Not defined
Vomiting Yes Not defined Yes Not defined
Pseudomembranous colitis Yes Not defined Yes Not defined
Rash Yes Not defined Yes Not defined
Urticaria Yes Not defined Yes Not defined
Dizziness Yes Not defined Yes Not defined
Headache Yes Not defined Yes Not defined
Jaundice Yes Not defined Yes Not defined
Anaphylaxis Yes Not defined Yes Not defined
Mucocutaneous candidiasis No Not defined Yes Not defined
Black hairy tongue No Not defined Yes Not defined

Source: Cephalexin (DailyMed) Amoxicillin (DailyMed)

Drug interactions of cephalexin vs. amoxicillin

Cephalexin may increase the serum concentrations of the common antidiabetic agent metformin. Most courses of cephalexin are a short duration, so the drugs may be used concurrently as long as the patient is monitored.

Amoxicillin may interfere with the serum concentrations of important immunosuppressants. Serum concentrations of methotrexate have been shown to be increased with concurrent use with amoxicillin, while mycophenolate concentrations may be decreased. These immunosuppressant drugs are used in patients with serious conditions, and therefore patients who require the use of amoxicillin while on these drugs should be monitored closely.

Probenecid, when given with cephalexin or amoxicillin, may increase the serum concentrations of either antibiotic. While the use of both at the same time is not contraindicated, patients should be monitored.

Metformin Biguanide, Antidiabetic Yes No
Methotrexate Antifolate, Immunosuppressant No Yes
Mycophenolate Immunosuppressant No Yes
Probenecid Uricosuric Yes Yes
Tetracyclines Antibiotic No Yes
Vitamin K Coagulant Yes Yes

Warnings of Cephalexin and amoxicillin

Patients with a penicillin allergy should not take amoxicillin. There is evidence to suggest that patients with a penicillin allergy may also have a cross-sensitivity to cephalosporins, including cephalexin. Caution should be used when prescribing cephalexin in penicillin-allergic patients with no prior use of cephalosporins.

Pseudomembranous colitis is a rare but serious condition. It involves the swelling and inflammation of the colon due to an overgrowth of clostridium difficile. Pseudomembranous colitis can occur with a variety of antibiotics, including cephalexin and amoxicillin.

Cephalexin and amoxicillin are renally excreted. Patients with decreased or impaired renal function must have their doses adjusted accordingly.

Cephalexin is considered pregnancy category B, meaning that animal studies have not shown any teratogenic effects. It is considered generally safe in pregnancy. Cephalexin crosses into breast milk but is generally considered safe while breastfeeding.

Amoxicillin is also considered pregnancy category B. It is considered generally safe in pregnancy. Amoxicillin crosses into breast milk but is also considered safe while breastfeeding.

Frequently asked questions about cephalexin vs. amoxicillin

What is cephalexin?

Cephalexin is a first-generation, cephalosporin antibiotic. It belongs to a bigger classification of antibiotics known as beta-lactam antibiotics. It is generally effective against bacteria involved in upper and lower respiratory tract infections, otitis media, mastitis, and skin, bone, and joint infections.

What is amoxicillin?

Amoxicillin is a penicillin derivative antibiotic. It belongs to a bigger classification of antibiotics known as beta-lactam antibiotics. It is generally effective against bacteria involved in upper and lower respiratory tract infections, otitis, media, and skin infections.

Are cephalexin and amoxicillin the same?

While cephalexin and amoxicillin are each beta-lactam antibiotics, they are not the same. Cephalexin is a cephalosporin antibiotic, and amoxicillin is a penicillin derivative. While they cover some of the same bacterial organisms, they each cover unique organisms.

Is cephalexin or amoxicillin better?

There are many factors to choosing the most effective antibiotic for any infection. While one study showed that amoxicillin may be associated with more relapses of strep pharyngitis versus cephalexin, it remains in the treatment guidelines as the first-line treatment.

Can I use cephalexin or amoxicillin while pregnant?

Cephalexin and amoxicillin are considered safe during pregnancy. There is no known harm to the fetus despite the fact that both drugs cross the placenta.

Can I use cephalexin or amoxicillin with alcohol?

While there is no contraindication to taking these antibiotics while consuming alcohol, patients should be aware that alcohol consumption may increase the risk of gastrointestinal side effects.

Is cephalexin or amoxicillin stronger?

When dosed appropriately, both antibiotics are effective against their covered organisms. The organism coverage of cephalexin makes it effective in some conditions that amoxicillin is not, including mastitis and bone and joint infections.

How quickly does cephalexin work?

Antibiotics begin working against the organism as soon as you begin therapy. It may take several days before a patient begins to experience symptomatic relief depending on the type of infection.

Is amoxicillin or cephalexin better for ear infection?

The American Academy of Family Physicians (AAFP) maintains in its guidelines that amoxicillin is the treatment of choice for otitis media. Other antibiotics, like cephalosporin, may be used when there is an allergy or if resistance is suspected.

Symptoms, Home Remedies & Food Allergies

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Treating Sinus Infections: Don’t rush to antibiotics

Treating Sinus Infections: Don’t rush to antibiotics

Millions of people are prescribed antibiotics each year for sinus infections, a frequent complication of the common cold, hay fever, and other respiratory allergies. In fact, 15 to 21 percent of all antibiotic prescriptions for adults in outpatient care are for treating sinus infections. Unfortunately, most of those people don’t need the drugs. Here’s why:

The drugs usually don’t help.

Sinus infections can be painful. People with the condition usually have a stuffy nose combined with yellow, green, or gray nasal discharge plus pain or pressure around the eyes, cheeks, forehead, or teeth that worsens when they bend over. But sinus infections almost always stem from a viral infection, not a bacterial one—and antibiotics don’t work against viruses. Even when bacteria are the cause, the infections often clear up on their own in a week or so. And antibiotics don’t help ease allergies, either.

They can pose risks.

About one in four people who take antibiotics have side effects, such as stomach problems, dizziness, or rashes. Those problems clear up soon after stopping the drugs, but in rare cases antibiotics can cause severe allergic reactions. Overuse of antibiotics also promotes the growth of bacteria that can’t be controlled easily with drugs. That makes you more vulnerable to antibiotic-resistant infections and undermines the good that antibiotics can do for others.

So when are antibiotics necessary?

They’re usually required only when symptoms last longer than a week, start to improve but then worsen again, or are very severe. Worrisome symptoms that can warrant immediate antibiotic treatment include a fever over 38.6°C, extreme pain and tenderness over your sinuses, or signs of a skin infection, such as a hot, red rash that spreads quickly. When you do need antibiotics, the best choice in many cases is amoxicillin, which typically costs about $4 and is just as effective as more expensive brand-name antibiotics. Note that some health care providers recommend CT scans when they suspect sinus infections. But those tests are usually necessary only if you have frequent or chronic sinus infections or you’re going to have sinus surgery.

How should you treat sinus infections?

Most people recover from sinus infections caused by colds in about a week, but several self-help steps may bring some relief sooner:

Rest. That’s especially important in the first few days when your body needs to channel its energy into fighting the virus. It also helps to elevate your head when lying down to ease postnasal drip.

Drink. Warm fluids can help thin nasal secretions and loosen phlegm.

Boost humidity. Warm, moist air from a bath, shower, or a pan of recently boiled water can loosen phlegm and soothe the throat.

Gargle. Use half a teaspoon of salt dissolved in a glass of warm water.

Rinse your nose. Saltwater sprays or nasal irrigation kits (such as Neti Pot) might make you feel better.

Use over-the-counter remedies with caution.

  • Nasal drops or sprays containing oxymeta- zoline (such as Otrivin, Drixoral and generic) can cause rebound congestion if used for longer than three days.
  • The benefits of oral decongestants (such as Sudafed) rarely outweigh the risks or side effects.
  • Unless significant allergies are present, it’s best to skip antihistamines since they don’t ease cold symptoms very much and can cause bad side effects.

Do They Help? Types, Side Effects, & More

Patients with painful sinus problems often plead with their doctors to give them an antibiotic ASAP.

About 90% of adults seen in the U.S. by a general practice physician do end up getting an antibiotic for acute sinusitis, research has found.

Acute sinusitis is a sinus infection that lasts less than four weeks. Chronic sinusitis lasts longer than 12 weeks. Infections of the sinuses, hollow air spaces within the bones in the cheek bones, forehead and between the eyes, are usually caused by viral or bacterial infections. They cause thick mucus blockage and discomfort of theses cavities.

But antibiotics may not always be the best remedy for sinusitis, according to recent research and physician experts. Your body should be able to cure itself of a mild or moderate sinusitis and avoid antibiotics that can cause antibiotic resistance.

Judicious use of antibiotics is now recommended by many agencies that have published guidelines, including practice guidelines issued jointly by the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology.

Research into Antibiotics and Sinus Infections

The guidelines were triggered, in part, by studies finding that antibiotics may not make a difference. About 60% to 70% of people with sinus infections recover without antibiotics, according to the American Academy of Allergy, Asthma & Immunology.

In one study of symptom relief, patients given antibiotics generally did no better than patients not given antibiotics.

This study, published in the Journal of the American Medical Association, observed 240 patients with sinusitis. They were given one of four treatments: antibiotics alone, nasal steroid spray alone to reduce tissue swelling, both antibiotics and the spray, or no treatment.

Patients who got no treatment were as likely to get better than those who got the antibiotics. The nasal spray seemed to help people with less severe symptoms at the beginning of their sinus problem, and seemed to make those with more intense congestion worse.

The patients all had sinus symptoms that suggested a bacterial infection. Sinus problems are also caused by viruses, for which antibiotics definitely offer no help.

Is Your Sinus Infection Caused by a Virus or Bacteria?

Physicians may not know if sinusitis is bacterial or viral, because the diagnosis is typically done by observing symptoms. Symptoms include:

  • Nasal congestion
  • Pain or discomfort around the eyes, forehead or cheeks
  • Cough
  • Headache
  • Thick nasal or post-nasal drainage

Sometimes other tests such as computed tomography (CT) scan or cultures are used to help make the diagnosis.

Despite the recommendations that antibiotic use be judicious, they are still overused for sinusitis, according to many physicians who specialize in treating sinus problems.

Some physicians say they give patients with sinusitis a prescription for antibiotics, and recommend they wait three to five days before filling it, and only fill it if symptoms are not better by then. A decongestant can be used to help relieve your symptoms and promote drainage.

The longer symptoms last, the more likely a sinus problem is to be a bacterial infection, some experts say.

When Antibiotics Are Appropriate Treatment

Antibiotics may be given to people who are less able to fight off infection, such as those with diabetes, or serious heart or lung disease.

Continued

In addition, antibiotics can be given to those whose symptoms have gotten worse or those who show no improvement after seven days.

If antibiotics are given, a 10- to 14-day course is recommended, according to the practice guidelines. Amoxicillin (Amoxil) or amoxicillin clavulanate (Augmentin) are typically the first choice for people who are not allergic to penicillin.

Don’t treat sinus infections with antibiotics

By MyHealthNewsDaily Staff

Most people who have sinus infections should not be treated with antibiotics because the drugs are unlikely to help, according to new guidelines from infectious disease experts.

Although sinus infections are the fifth-leading reason for antibiotic prescriptions, 90 to 98 percent of cases are caused by viruses, which are not affected by antibiotics, according to the guidelines issued today (March 21) by the Infectious Diseases Society of America. Used inappropriately, antibiotics spur the development of drug-resistant superbugs, the IDSA says.

“There is no simple test that will easily and quickly determine whether a sinus infection is viral or bacterial, so many physicians prescribe antibiotics ‘just in case,'” said Dr. Anthony Chow, professor emeritus of infectious diseases at the University of British Columbia, Vancouver and chairman of the guidelines panel.

“However, if the infection turns out to be viral — as most are — the antibiotics won’t help and in fact can cause harm by increasing antibiotic resistance, exposing patients to drug side effects unnecessarily and adding cost,” Chow said.

A study of 166 people with sinus infections published in February in the Journal of the American Medical association showed that those who took antibiotics saw no better improvement in their symptoms than those taking a placebo.

The new guidelines provide specific characteristics of the illness to help doctors distinguish between viral and bacterial sinus infections.

How to tell if it’s bacterial

A sinus infection, properly called acute rhinosinusitis, is inflammation of the nasal and sinus passages that can cause uncomfortable pressure on either side of the nose, and last for weeks. Most sinus infections develop during or after a cold or other upper respiratory infection, but other factors such as allergens and environmental irritants may play a role.

According to the guidelines, a sinus infection is likely caused by bacteria, and should be treated with antibiotics, if any of these criteria are met:

  • symptoms last for 10 days or more and are not improving (previous guidelines suggested waiting seven days)
  • symptoms are severe, including fever of 102 degrees Fahrenheit or higher, nasal discharge and facial pain lasting three to four days in a row
  • symptoms get worse, with new fever, headache or increased nasal discharge

For adults, 5 to 7 days is enough

The guidelines recommend treating bacterial sinus infections with amoxicillin-clavulanate, instead of the drug currently used, amoxicillin, because the addition of clavulanate helps to thwart the development of antibiotic resistance. The guidelines also recommend against using other commonly used antibiotics, due to increasing drug resistance.

While previous guidelines have recommended taking antibiotics for 10 days to two weeks, the new guidelines suggest five to seven days of antibiotics is long enough for the treatment of adults, and will not encourage bacterial resistance. The IDSA guidelines still recommend children receive antibiotic treatment for 10 days to two weeks.

Whether a sinus infection is bacterial or viral, decongestants and antihistamines are not helpful and may make symptoms worse, the guidelines say.

The voluntary guidelines are not intended to take the place of a doctor’s judgment, but rather support the decision-making process, which must be made according to each patient’s circumstances, the IDSA says.

The guidelines will be published in the April 15 issue of the journal Clinical Infectious Diseases.

More from MyHealthNewsDaily:

Which antibiotics are most effective for bacterial sinusitis (sinus infection)?

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  • [Guideline] Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr. 152 (2 Suppl):S1-S39. [Medline].

  • Hansen JG, Schmidt H, Rosborg J, Lund E. Predicting acute maxillary sinusitis in a general practice population. BMJ. 1995 Jul 22. 311(6999):233-6. [Medline]. [Full Text].

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  • Marple BF, Roberts CS, Frytak JR, Schabert VF, Wegner JC, Bhattacharyya H, et al. Azithromycin extended release vs amoxicillin/clavulanate: symptom resolution in acute sinusitis. Am J Otolaryngol. 2010 Jan-Feb. 31(1):1-8. [Medline].

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  • Cephalexin User Reviews for Upper Respiratory Tract Infection at Drugs.com

    Also known as:
    Keflex

    Cephalexin has an average rating of 6.9 out of 10 from a total of 19 ratings for the treatment of Upper Respiratory Tract Infection.
    58% of those users who reviewed Cephalexin reported a positive effect, while 26% reported a negative effect.

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    90,000 Antibiotics for short-term sinus infections in adults

    Review question

    Is antibiotic treatment faster than antibiotic treatment for sinus infections in adults?

    Relevance

    A sinus is a cavity located in the head. Adults with short-term sinus infections have nasal congestion and thick, yellow discharge from the nose. People with a sinus infection may feel mucus on the back of the throat, facial pain, pain when bending forward, and pain in the upper jaw or when chewing.A short-term sinus infection can be suspected after a physical examination and questioning about symptoms. Blood tests and sinus imaging can confirm the diagnosis, but are not routinely recommended in most countries. Viruses are the most common cause of short-term sinus infections. However, doctors may prescribe antibiotics, which should only be used to treat bacterial infections. Taking antibiotics unnecessarily leads to antibiotic resistance in bacteria. We assessed whether antibiotics could cure adults with short-term sinus infections more quickly compared to pacifiers (placebo) or no treatment.

    Search date

    January 18, 2018.

    Research characteristics

    We included 15 studies in which adults with short-term sinus infection, confirmed or unconfirmed by imaging, were randomly assigned to receive antibiotics, pacifiers, or no treatment on an outpatient basis. The studies enrolled 3,057 adults with an average age of 36; about 60% of the participants were female.Participants were followed until cured. The duration of the trials ranged from 8 to 28 days.

    Sources of research funding

    Seven studies received financial support from government or academic institutions; six – grants to the pharmaceutical industry; five did not report sources of funding.

    Highlights

    Without antibiotics, almost half of all participants were cured after 1 week, and two-thirds after 14 days.For every 100 participants, out of 5 (diagnosed based on symptoms described to the doctor) – 11 (diagnosed with x-ray) more people healed faster with antibiotics. Computed tomography (CT) scans can predict who will benefit from antibiotics, but its routine use can lead to health problems due to radiation exposure. For every 100 participants, 10 more people got rid of thick, yellow nasal discharge faster with antibiotics compared to dummy medication or no treatment.For every 100 participants, 30 more people experienced side effects (mostly from the stomach or intestines) with antibiotics versus dummy medication or no treatment. When compared to people who took antibiotics initially, an additional 5 out of 100 people in the dummy drug or no treatment groups were forced to start taking antibiotics because the condition worsened. Serious complications (eg, brain abscess) were rare.

    We have found that antibiotics are not first line treatment for adults with short-term sinus infections.We found no evidence for adults with severe sinusitis or immunosuppression, or children.

    Quality of evidence

    When the diagnosis was based on symptoms reported to a physician, the quality of the evidence was high. We reduced the quality of the evidence to moderate when the diagnosis was confirmed by X-ray or CT, as the number of participants was small and the estimate became less reliable.

    Antibiotics for sinusitis

    Sinusitis is a serious disease, the development of which is based on inflammation of the paranasal (maxillary) sinuses.In most cases, pathogenic microorganisms are the cause of the development of pathology. Predisposing factors include low immunity protection, anatomical features of the nasal passages, paranasal cavities, as well as post-traumatic changes in this area, which disrupt ventilation in the sinuses, narrow the nasal passages.

    Untimely initiation of therapy can lead to the development of severe complications, namely, infection of the ear cavity, the meninges of the brain. Sinusitis can be suspected based on the following symptoms:

    • mucous discharge from the nose, which gradually becomes purulent and bothers more than a week;
    • nasal congestion due to tissue edema, hypersecretion, which forces a person to breathe through the mouth;
    • lack of smell;
    • taste change;
    • fever above 39 degrees;
    • pain in the paranasal region, which spreads to the forehead, eye sockets, teeth and worsens when bending, turning the head;
    • malaise;
    • drowsiness;
    • decreased physical activity.

    In order to diagnose the disease in time, it is necessary to be examined by a doctor at the stage of the appearance of the first clinical signs of pathology. You can consult a qualified otolaryngologist at the Capital Health Medical Center. Experienced specialists of various profiles work here, which allows providing medical assistance to adults and children.

    Treatment of sinusitis is based on the use of antibacterial agents. They can be used topically or systemically.Depending on the severity of the disease, the patient’s state of health, drugs can be prescribed for oral administration or injection (intramuscularly, intravenously).

    Note that the dose of drugs, the type of antibiotic and the duration of therapy are determined exclusively by the doctor based on the results of instrumental, laboratory examination. Self-administration of medications can not only not bring relief to the general condition, but also worsen the course of the disease, provoke the appearance of adverse reactions.

    Next, consider the groups of antibacterial agents that are most often used in the treatment of sinusitis.

    • Penicillin series. The drugs are available in combination with clavulanic acid. Representatives of this group of antibiotics include Flemoxin, Amoxiclav, Augmentin, Flemoxin. Medicines are widely used in the treatment of sinusitis in babies. For them, preparations are sold in the form of a suspension with the addition of fruit fillers to impart a pleasant taste.
    • Cephalosporins such as Ceftriaxone, Cefuroxime, Zefter.The drugs are divided by generation, depending on the spectrum of action against pathogenic microorganisms. The choice of a medicine is carried out on the basis of the results of bacterial sowing of biological material.
    • Macrolides (Clarithromycin, Sumamed, Fromilid, Macropen) – act on intracellular bacteria (chlamydia, mycoplasma). They are prescribed when the above antibiotics cannot be used due to allergic reactions or their ineffectiveness.

    For local therapy, antibiotics from the aminoglycoside group are prescribed.They have a greater number of side effects in comparison with other drugs, therefore, they are extremely rarely prescribed for systemic administration.

    Polydex drops are used for intranasal administration. In their composition, they have not only an antibiotic, but also a vasoconstrictor, hormonal component. Spray Isofra is also prescribed for topical use. In addition to antibacterial drugs, saline solutions are prescribed to rinse the nasal passages.

    An integrated approach to therapy allows you to overcome infection, reduce inflammation, eliminate nasal congestion, restore nasal breathing, alleviate the general condition of a person, and prevent the development of complications.

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