Antibiotics for sinusitis in adults are prescribed quite often, and they have already become a classic way to get rid of this pathology. However, antibiotic therapy can only be started after consulting a doctor. The fact is that the treatment of sinusitis with antibiotics is not always effective, since the appropriateness of their use depends on the type, stage, severity and symptoms of the disease, which can only be accurately determined by a specialist.
So, antibiotics for purulent sinusitis have an extremely positive effect in the fight against infection, while in other types of the disease they will not only be useless, but can also harm the patient's body. In addition, the modern pharmacological market offers a wide range of different drugs. Only an otolaryngologist can choose which antibiotics to take with sinusitis, who will be based on a previous history of the disease and take into account the characteristics of a particular organism.
Types of sinusitis
Before asking the question "What antibiotics are used to treat sinusitis?" It depends mainly on the nature of the disease. According to its etiology, inflammation of the maxillary sinuses is:
- bacterial,
- viral,
- allergic,
- odontogenic (dental problems become the cause of the disease),
- fungal,
- traumatic.
Often, different types of maxillary sinusitis are accompanied by similar symptoms, so it can be difficult to independently identify the cause of the development of the pathology. As noted above, antibiotic treatment is not always beneficial, or rather, it will be appropriate only in one case - if the disease is of a bacterial nature. In such a situation, antibacterial drugs are prescribed against sinusitis, which slow down growth and reproduction (bacteriostatic antibiotics) or destroy (bactericidal antibiotics) pathogenic microorganisms.
If the disease is provoked by an allergic reaction of the body, injury, the appearance of neoplasms in the nasal cavity or inflammation of the upper teeth, the roots of which may be in the lower part of the sinus, then, firstly, it is necessary to consult an appropriate specialist (allergist, surgeon or dentist). Secondly, diseases of this type are treated with completely different medicines. Sometimes, in order to fix the problem, it is even necessary to perform a surgical intervention.
When treating sinusitis of a viral nature, which occurs with almost every cold, no special therapy is prescribed. Various rhinoviruses and adenoviruses that enter the nasal cavity, along with the inhaled air, are also carried along the paranasal sinuses, causing an inflammatory process there (edema and intense production of mucous masses). However, if you start on time and responsibly approach the treatment of acute respiratory viral infection, then the swelling of the paranasal sinuses will pass along with the disappearance of the symptoms of ARVI.
Since inflammation of the maxillary sinuses in most cases occurs against the background of a prolonged cold, many people try to protect themselves by using antibacterial drugs to prevent complications. However, the antibiotic used for sinusitis caused by an infection of non-bacterial origin does not at all contribute to the patient's recovery. Moreover, if a potent drug is taken in pill form, it can lead to disruption of the gastrointestinal tract (dysbiosis).
Even topical antibiotics that bypass the gastrointestinal tract and are intended directly for the nose (sprays, drops) are contraindicated to drink without a doctor's prescription, since pathogenic bacteria develop resistance to an antibacterial substance and in a situation where an antibiotic is really needed by the body, it may not bring the proper result. However, it happens that bacteria over time attach to a viral or any other type of sinusitis, then it is impossible to avoid antibiotic treatment.
Finally, taking into account the speed and characteristics of the course of the disease, distinguish between chronic and acute forms of sinusitis.
During the period of remission of a chronic disease, experts do not recommend the use of antibiotics, since at this stage other methods of treatment become more effective (for example, physiotherapeutic procedures such as ultrasound, UHF, microwave, electrophoresis, etc., help well).
Antibiotic therapy is prescribed during the period of exacerbation of the pathology.
Symptoms of bacterial sinusitis
In order to correctly and in time to recognize purulent sinusitis in adults or not to miss the moment when a bacterial infection joins a viral infection, you need to know what symptoms are characteristic of this type of disease. As a rule, the classic clinical picture of rhinitis or viral sinusitis (severe nasal congestion, partial loss of smell) is replenished with the following manifestations:
- foul-smelling yellowish-green nasal discharge;
- feeling of heaviness, pressure and pain in the head;
- pain at the site of the maxillary sinuses and the bridge of the nose;
- subfebrile temperature (37.1 - 38 degrees).
When the above symptoms appear, you must immediately seek medical advice, since the treatment of purulent sinusitis in the initial stages will allow you to recover quickly enough, and most importantly, it will not entail any consequences. If, with pronounced symptoms, the patient delays with treatment, refuses to drink antibiotics for sinusitis or, on the contrary, self-medicates, independently choosing which antibiotics to drink, there is a risk of developing serious complications in the form of neuritis of the facial nerve, problems with the organs of hearing and vision, meningitis, periostitis, etc. .d.
General rules of antibiotic therapy
It is categorically impossible to rely on the advice and experience of friends or independently decide which antibiotic for sinusitis should be taken, since there is no single universal recipe for everyone. For 
In order to select the most effective antibacterial drugs for a patient, a qualified otolaryngologist takes into account:
- medical history (when the disease occurred, what treatment was undertaken, what is the nature of the manifestations of the pathology);
- examination and test results (complete blood count, X-ray, and sometimes even bacterial culture);
- information about previous antibiotic therapy (if the drug has already been used, there is a risk of reducing its effectiveness for the patient during subsequent courses of treatment);
- information about individual intolerance to certain drugs;
- age and condition (some medicines are prohibited for use by children, pregnant or lactating women).
In addition, you should know that antibiotics for sinusitis usually have an immediate effect. As a rule, approximately 12 hours after the start of taking the prescribed tablets, the patient feels a significant improvement in his condition. However, despite the positive dynamics, the course of antibiotic therapy must be completely completed, otherwise there is a risk of recurrence of the disease or its chronicity.
If, after 24 or a maximum of 48 hours after the start of taking the drug, the patient does not observe any positive changes, then the treatment should be discontinued, since it will not give the desired result.
The lack of effect may be due to both the resistance of bacteria to this drug and the fact that a stronger drug is needed for treatment. In such situations, the doctor prescribes another drug or, in especially severe cases, punctures the sinus. The puncture is performed for diagnostic purposes, and a sample of the contents of the sinuses is sent for analysis (culture), after which you can pick up effective antibiotics for sinusitis.
Also, when treating inflammation of the maxillary sinuses, it is extremely important to adhere to the dosage prescribed by your doctor. Fearing dysbiosis, patients independently reduce the amount of medication taken or, at their own discretion, reduce the course of treatment, hoping that such an amount of medication or such a period will be enough to combat the pathology. However, an antibiotic taken at a lower dosage than the doctor's prescription requires can harm the body more than an increased dose.
You should be aware that, in general, the ability of antibacterial drugs to have a detrimental effect on the intestinal flora is greatly exaggerated. And the main danger, as a rule, comes from those very reduced doses, since the drug does not work at full strength. In addition, there is a risk that some of the pathogenic microorganisms will remain alive and develop resistance to the medication taken. In addition, there are cases when both children and adults can drink low-toxic antibiotics with sinusitis, completely minimizing their negative effect on the body. This happens if the patient seeks help in the early stages of the development of the disease.
With regard to contraindications to the use of antibacterial drugs, it is mainly an individual intolerance to certain components of the drug. Also, the choice of antibiotics should be approached with caution if a patient with sinusitis has chronic diseases of the digestive system, liver or kidneys. Finally, there is a long list of antibiotics that are contraindicated in children and pregnant or lactating women.
Groups and forms of antibiotics
Antibiotics are divided into groups according to their chemical structure. During the treatment of sinusitis, they usually use:
- Protected aminopenicillins. Considering that over the years of use, many bacteria have developed resistance to penicillins, now clavulanic acid or sulbactam is added to them, which neutralize the resistance of pathogens. Many believe that this is the best antibiotic for sinusitis in children. However, the disadvantage is that it often causes an allergic reaction. This group includes: Amoxiclav, Flemoklav, Ekoklav, Augmenty, Rapiklav, Panklav, Sultasin, Unazin, Ampisid, Libaktsil, Sulbatsin, Sultamicillin, etc.
- Macrolides. They are considered the safest drugs, since they are the least likely to provoke allergic reactions. Unlike penicillins, they act bacteriostatically - they are suitable for use in chronic sinusitis. This group includes: Erythromycin, Roxithromycin, Clarithromycin, Azithromycin, Midecamycin, Spiramycin, Josamycin, etc.
- Cephalosporins. More powerful antibiotics that are indicated for severe inflammation. This group of antibiotics is absolutely incompatible with alcohol, since the active substance inhibits the synthesis of an enzyme in the body that neutralizes the toxic effect of alcohol. This group includes: Cefazolin, Cefalexin, Cefuroxime, Cefoxitin, Cefixime, Ceftriaxone, Cefpirom, Cefepim, Ceftobiprol, Ceftolosan, etc.
- Fluoroquinolones. Fully synthetic drugs that have a very broad spectrum of action. However, due to their artificial origin and high toxicity, they often cause allergies and side effects. For pregnant and lactating women, such drugs are categorically contraindicated, and in the treatment of children they are used in the most extreme cases. This group includes: Ofloxacin, Pefloxacin, Norfloxacin, Ciprofloxacin, Levofloxacin, Sparfloxacin, Hemifloxacin, Moxifloxacin, etc.
Antibacterial drugs can enter the body in different ways, depending on the form of release of the drug. There are antibiotics in the form of tablets, drops, sprays, syrups, suspensions, suppositories and injections. In what form and what kind of antibiotic is best used in a particular situation, only the attending physician can decide, who takes into account the results of the examination. If the severity 
pathology is low, then, as a rule, local antibiotics are prescribed, which are used for sinusitis directly into the nose (sprays, drops).
The names of the most popular and effective means are Bioparox and Isophora. These drugs do not have a very aggressive effect on the body and practically do not cause side effects in patients. However, you should definitely pay attention to the fact that in order to obtain a therapeutic effect, the medicinal substance must go directly into the focus of infection - into the nasal cavity and maxillary sinuses. Thus, before the administration of drugs, it is necessary to apply vasoconstrictor drops and clear the nasal passages of pathological mucopurulent secretions.
Antibiotics for sinusitis in tablets (systemic action) are used if the disease cannot be treated with local remedies or, at the time of the start of treatment, the pathology is already at an advanced stage.
The complex use of tablets and drops / sprays at the same time is also practiced. In extreme cases, if the patient's condition is constantly deteriorating, then they switch to the injectable form of antibiotic therapy. Nevertheless, in such a situation, the risk of developing an allergic reaction is too high, therefore, injections are recommended to be given only on an outpatient basis.
