Antibiotics for sinusitis: treatment in adults and children
The content of the article:
- How to choose the most effective antibiotic for sinusitis
- Contraindications for antibiotic therapy for sinusitis
- Potential Side Effects of Antibiotic Treatment
- Groups of antibacterial drugs
-
Antibiotics for sinusitis
- Penicillin antibiotics
- Macrolides
- Fluoroquinolones
- Cephalosporins
- Local antibiotics
- Video
Sinusitis is a type of sinusitis - inflammation of the paranasal sinuses, which most often develops as a result of infection.
Depending on the affected area, there are:
- sinusitis (another name is maxillitis, maxillary sinusitis): inflammation develops in the maxillary sinuses;
- frontal sinusitis: the most severe form of pathology, the inflammatory process occurs in the frontal sinus;
- ethmoiditis: the infection develops in the cavities of the ethmoid bone;
- sphenoiditis: inflammation of the sphenoid sinus, usually associated with ethmoiditis and is the most difficult to diagnose form of the disease.
To diagnose the disease and prescribe adequate treatment, you need to contact an otolaryngologist
In the absence of timely treatment of sinusitis, various complications are possible, including meningitis, otitis media, adenoiditis, tonsillitis, bronchitis, nephropathy and others.
The main causes of the development of the disease are bacterial and viral infections that enter the maxillary sinus through the blood or the nasal cavity, through pathological processes occurring in the periapical regions of the upper teeth. Sinusitis can also be a complication of influenza or ARVI (acute respiratory viral infection).
Sinusitis is characterized by typical symptoms - headache, profuse nasal discharge, fever
Common symptoms of maxillary sinusitis are: profuse nasal discharge, soreness in the eye socket and forehead, facial sensitivity, fever, and headache. Inflammation provokes a violation of the outflow of secretions secreted by the mucous membrane of the maxillary sinus. This, in turn, leads to the development of pathology. The mucus under the influence of pathogenic microbes turns into pus. In the absence of timely treatment, sinusitis becomes chronic.
At the initial stages of treatment, inhalation, rinsing and instillation of the nasal cavity are prescribed. In order to properly carry out these procedures at home, it is better to consult a doctor, familiarize yourself with thematic photos or videos. If the sinusitis has not gone away for 7-10 days, antibacterial drugs are used to get rid of the infection and clear the maxillary sinuses from the accumulated pus.
How to choose the most effective antibiotic for sinusitis
Antibiotic therapy should be prescribed by an otolaryngologist (ENT), since he will be able to determine whether it should be carried out and will select the most effective drug. To this end, the doctor collects information about the history of the disease, takes into account the test results, the age of the patient, the presence of allergies, takes into account information about previously taken antibacterial agents.
Do not use antibiotics without a doctor's prescription
Based on the data obtained, the ENT prescribes an antibiotic to the patient, to which there are no contraindications or allergies, and the causative agent of the disease is most sensitive. Most of the new generation antibiotics have a broad spectrum of action and are active against almost all bacteria that cause ENT diseases. In this regard, the need for bacterial inoculation to establish a specific causative agent of the disease arises only in cases where there is no effect with the ongoing drug treatment.
Antibiotics come in a variety of dosage forms, including tablets, nasal rinses, sprays, drops, and injection solutions. Self-selection of the drug is not recommended, since it may be ineffective and even aggravate the patient's condition.
Contraindications for antibiotic therapy for sinusitis
Most broad-spectrum antibacterial agents are contraindicated or used with extreme caution in the following cases:
- pathology of the kidneys and / or liver;
- cardiovascular diseases;
- allergic, fungal or viral sinusitis;
- children under 12 years of age;
- pregnancy;
- period of breastfeeding;
- hypersensitivity to the components that make up the antibiotic.
A detailed list of absolute and relative contraindications is indicated in the instructions for the drug.
Potential Side Effects of Antibiotic Treatment
With the correct selection of an antibacterial agent, an improvement in the patient's condition is observed in a short time. However, even with the use of a suitable drug, side effects such as:
- swelling of the throat or face;
- difficulty breathing;
- rash, redness and other skin manifestations;
- fainting;
- increased dizziness;
- disorders of the gastrointestinal tract.
It is important to consult a doctor in a timely manner if adverse reactions occur. Self-selection of drugs in such cases, without taking into account their possible interaction with the antibiotic taken, can lead to the development of serious complications.
A detailed list of possible side effects is indicated in the instructions for use of the drug.
Groups of antibacterial drugs
Antibiotics are substances of synthetic, semi-synthetic or natural origin that inhibit the growth of living cells.
By the nature of the effect on the bacterial cell, they are divided into two groups:
- bactericidal: when taken, bacteria die and are removed from the body;
- bacteriostatic: bacteria after using such agents remain alive, but their reproduction becomes impossible.
By chemical structure, the following antibacterial agents are distinguished:
- β-lactam: a group of antibiotics that contain a β-lactam ring in their structure. They are classified as penicillins, cephalosporins, carbapenems, and monobactams. Penicillins produce colonies of the Penicillium mold. Cephalosporins are similar in structure and are used against penicillin-resistant bacteria. The structure of carbapenems is more resistant to β-lactamases than that of penicillins and cephalosporins, due to which they have a wider spectrum of action;
- macrolides: have a bacteriostatic effect, have a complex cyclic structure;
- tetracyclines: bacteriostatic antibiotics used to treat urinary and respiratory tract infections, severe infections such as brucellosis, tularemia and anthrax;
- aminoglycosides: have a bactericidal effect, are highly toxic. They are used for severe infections (blood poisoning, peritonitis);
- chloramphenicol: have a bacteriostatic effect, their use is limited, since against the background of their intake, it is possible to damage the bone marrow, which produces blood cells;
- glycopeptides: disrupt the synthesis of the cell wall of bacteria, have a bactericidal effect, but in relation to enterococci, some streptococci and staphylococci, they act bacteriostatically;
- lincosamides: by inhibiting protein synthesis by ribosomes, they have a bacteriostatic effect. When taken in high concentrations, a bactericidal effect may appear against highly sensitive microorganisms;
- anti-tuberculosis drugs: antibiotics active against Koch's bacillus;
- antibiotics of different groups (Heliomycin, Fusidin sodium, Rifamycin and others);
- antifungal antibiotics: have a lytic effect, destroy the membrane of fungal cells and cause their death;
- antileprosy agents (Diucifon, Solusulfone, Diaphenylsulfone).
For the treatment of sinusitis with antibiotics in adults and children, macrolides, penicillins, fluoroquinolones and cephalosporins are used.
Antibiotics for sinusitis
Antibacterial treatment is prescribed for acute maxillitis and the development of serious complications against the background of a chronic form of inflammation. It can be carried out at home or, in case of severe disease, in a hospital. In most cases, drug therapy is beneficial and the patient is recovering quickly. If there is no improvement within three days of taking the medication, it is recommended to consult a doctor. He will decide how to treat the disease further, and what antibiotics will be effective in this case.
Antibiotics are prescribed only for acute sinusitis
It is important to complete the started course of antibiotics, even if there is no fever and other symptoms of sinusitis, and the general condition has improved. This is due to the fact that relapses of the disease are much more difficult to treat.
If the patient is prescribed local antibiotics (drops, sprays), it is imperative to cleanse the sinuses before using them. To prevent inflammation from getting worse, it is important to make sure that pus is draining from the inflamed cavities. Before using any antibiotics, you should check the condition of the gastrointestinal tract and kidneys, in order to avoid exacerbation of existing chronic pathologies or the development of dangerous complications.
Before administering antibiotics in the form of drops or a spray, it is necessary to clear the sinuses
The method of administration, doses, as well as how many days to take the drug, is determined by the otolaryngologist individually.
Penicillin antibiotics
- Hikontsil: available in the form of powder, capsules and drops for oral administration. Immediately before taking, the powder and drops are diluted in water. The duration of the course varies from 5 to 12 days;
- Amosin: a preparation in the form of a powder for the preparation of a suspension for oral administration. Its dose directly depends on the severity of the pathology. Usually, therapy is started with minimal doses, and equal intervals of time are observed between doses of the finished suspension during the day. It is recommended to drink the product no more than 12 days;
- Amoxicar: is a latest generation antibiotic that has a rapid therapeutic effect when used even in small doses. The course of medication is up to 14 days.
Penicillins are active against most gram-positive, as well as some gram-negative microorganisms
Penicillin drugs are among the safest antibiotics for the treatment of maxillitis, however, due to their long-term use, many bacteria have developed resistance to them.
Macrolides
- Clarithromycin: Available in capsule and tablet form, which are taken by mouth. The active substance, clarithromycin, quickly stops the negative effects of pathogenic bacteria, but it often causes side effects from the liver and stomach. With a mild course of inflammation, it is taken for 7 days (no more), in severe cases, the duration of the course can be increased to 14 days;
- Clarbact: a modern Indian antibiotic. It is produced in the form of coated tablets, which must be taken orally 1 hour after meals in the morning and evening. The dose of the drug is determined depending on the severity of the condition. The composition of Clarbact is the same as that of Clarithromycin, but it often leads to the development of side effects. The course of treatment should not exceed 14 days, in some cases it may be sufficient to receive it within 6 days;
- Ecositrin: A more potent macrolide antibiotic available in tablets. Its reception for a mild course of the disease varies from 7 to 14 days, with an acute form - 14 days.
Macrolides are often the antibiotic of choice in the treatment of sinusitis.
These antibiotics in tablets for sinusitis in adults are recommended for use in cases of intolerance to the penicillin group or ineffectiveness of previously conducted antibiotic therapy.
Fluoroquinolones
- Ofloxacin: a modern drug that suppresses many types of bacteria. It is well tolerated by patients, does not cause serious side effects. Available in tablets, which are recommended to be taken one hour after a meal. The duration of the course of treatment is established by the doctor;
- Moxifloxacin: Available in the form of an oral tablet and an infusion solution that is injected intravenously. For elderly patients, correction in the dosage regimen of Moxifloxacin is not required. The therapy is carried out under strict medical supervision for a period set individually.
The use of this modern group of antibacterial agents for the treatment of sinusitis is the most effective, since bacteria have not yet developed resistance to them. However, it should be borne in mind that in some cases, against the background of their use, severe allergic reactions may develop, which requires immediate hospitalization of the patient.
Cephalosporins
- Cefazolin: a first-generation antibiotic for cephalosporins. It is produced in the form of a powder for the preparation of a solution for injection. It is prescribed exclusively in the presence of intoxication of the body. The dosage and duration of the course of treatment is set individually for each patient. Before administration, the antibiotic is diluted in isotonic sodium chloride solution or sterile water for injection. The drug is rapidly absorbed, its concentration in the blood is maintained for 12 hours. Cefazolin is prescribed to patients with caution, since side effects from the gastrointestinal tract and allergies may develop during therapy;
- Ceftriaxone: a third-generation antibiotic produced in powder form for the preparation of a solution for intravenous and intramuscular administration. The drug is used only if there are signs of severe damage to the body by bacteria that provoke intoxication. The dose of Ceftriaxone is selected exclusively on an individual basis. Its use is possible only in the acute phase of the disease. In the stage of remission, its use is not recommended. The introduction of the solution is continued until the acute symptoms of sinusitis are completely removed.
Cephalosporins are prescribed only for severe sinusitis, when the use of other antibiotics has been ineffective. After stopping the acute period of the disease, they are immediately canceled.
Local antibiotics
- Isofra: produced in the form of a nasal spray, is introduced into each nasal passage by means of injections. The dosage is set depending on the severity of the inflammatory process. It is recommended to keep the same time interval between injections. Immediately before using the spray, the nasal cavity should be cleaned of discharge using special solutions (for example, Aqualor). Isofra therapy should not exceed 7 days;
- Framinazine: a topical preparation for nasal diseases containing an antibiotic. Available in the form of a nasal spray. In cases of damage to the nasal sinuses, Framinazin is not used. The frequency of use of the agent depends on the intensity of the inflammatory process. The duration of the course of therapy is set by the doctor, usually it does not exceed 10 days. When using the spray, there may be increased dryness of the nasopharynx;
- Polydex with phenylephrine: a combined drug, the active ingredients of which are antibiotics (neomycin and polymyxin B), a synthetic glucocorticosteroid (dexamethasone) and an α-adrenergic agonist (phenylephrine). Thanks to this composition, the drug acts quickly, and after the first use, the patient's condition improves significantly. The drug is available in the form of a nasal spray, it is recommended to inject it at regular intervals. The duration of therapy varies from 5 to 10 days.
It should be borne in mind that with the simultaneous appointment of sprays and vasoconstrictor drops, it is important to observe an interval of one hour between their administration. If the otolaryngologist has also prescribed rinsing solutions, they can be used at any time.
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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