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Nasal congestion; Rhinosinusitis
The primary objectives for treatment of sinusitis are reduction of swelling, eradication of infection, draining of the sinuses, and ensuring that the sinuses remain open. Fewer than half of patients reporting symptoms of sinusitis need aggressive treatment. Home remedies can be very useful.
Treatment of Acute Sinusitis.
Treatment of Chronic Sinusitis.
Home remedies that open and hydrate sinuses may, indeed, be the only treatment necessary for mild sinusitis that is not accompanied by signs of acute infection.
A nasal wash can be helpful for removing mucus from the nose. A saline solution can be purchased in a spray bottle at a drug store or made at home. (Mix 1 teaspoon of table, Kosher, or sea salt with 2 cups of warm water. Some people add a pinch of baking soda.) Perform the nasal wash several times a day. Researchers have reported that daily irrigation of the nasal passages with a hypertonic saline solution relieves sinusitis symptoms and also reduces antibiotic use and the occurrence of acute exacerbations.
A simple method for administering a nasal wash is:
Neti pots have also become popular in recent years for prevention and treatment of sinusitis. Nasal irrigation with a saline solution through a neti pot involves:
Overview on Antibiotics and Their Overuse. Sinusitis is the fifth most common diagnosis for antibiotic prescriptions. But there is much evidence that antibiotics are inappropriately prescribed for many patients:
When to Use Antibiotics. Antibiotics should usually be reserved for select patients who are at higher risk for developing bacterial infections. Because up to 80% of sinusitis cases resolve on their own within 2 weeks, doctors generally wait 7 - 14 days before prescribing antibiotics. Some doctors feel that antibiotics still should not be prescribed if symptoms last longer than 10 days. However, antibiotics may be prescribed sooner if severe symptoms develop. These symptoms include:
Chronic sinusitis is often the result of damage to the mucus membrane from a past, untreated acute sinus infection. The aerobic and anaerobic bacteria present in chronic sinusitis are often different from those that cause the acute form. The role of antibiotic treatment for chronic sinusitis is controversial. Special types of antibiotics may be used, and treatment may be needed for a longer time.
Some patients with chronic sinusitis may need intravenous antibiotic therapy, particularly those with underlying medical disorders that can worsen their condition. This therapy is typically given 2 weeks before surgery and continued for about a month afterwards.
Antibiotic Regimens.
Side Effects of Antibiotics. Most antibiotics have the following side effects (although specific antibiotics may have other side effects or fewer of the standard ones):
Patients often have various combinations of allergies, sinusitis, and asthma. Treating each condition is important for improving them all. In addition to decongestants, pain relievers, and expectorants, other remedies are available for people who suffer from nonbacterial sinusitis during allergy season.
Patients who show signs that infection has spread beyond the nasal sinuses into the bone, brain, or other parts of the skull need emergency care. High dose antibiotics are administered intravenously, and emergency surgery is almost always necessary in such cases.
Severe Fungal Sinusitis. Sinusitis caused by severe fungal infections is a medical emergency. Treatment is aggressive surgery, and high-dose antifungal chemotherapy with a drug such as amphotericin B can be life saving.
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