Sinus medications for acute viral sinusitis typically focus on reducing sinus and nose inflammation and keeping the drainage pathways open and properly functioning. Over-the-counter (OTC) medications are commonly recommended for children and adults to help relieve some symptoms such as a runny nose, congestion, fever, and aches, but they do not shorten the length of time you or your child is sick. Although prescription medications may be added in combination with OTCs to help decrease the severity and duration of symptoms. Some of the sinus medications commonly recommended or prescribed include:
Decongestant Nasal Sprays such as Afrin help to treat swelling but shouldn’t be used for more than 3 days.
Decongestants such as Sudafed help to relieve sinus pain and pressure but should only be used for a short time.
Eye Drops such as Olopatadine treat red, itchy eyes.
Nasal Antihistamines such as Azelastine help treat allergy symptoms.
Nasal Corticosteroids such as Flonase help with nasal congestion.
Nasal Irrigations such as a Neti pot help to flush your sinuses and help loosen thick mucus. (Note: When using a Neti pot be sure to use distilled or sterile water that has been boiled 3 to 5 minutes and cooled. Do not use regular tap water as it is not safe to use because it has not been properly filtered or treated, and could lead to serious infections in your nasal passages.)
Oral Antihistamines such as Claritin or Allegra help treat allergy symptoms.
Oral Steroids such as Prednisone treat both acute and chronic sinusitis.
Over-the-Counter Pain Relievers such as Motrin help to relieve pain and aches.
Over-the-Counter Cold Medicines such as Mucinex help to relieve cold symptoms–loosen phlegm and bronchial secretions–but check with your doctor first, as some of these medications may make your symptoms worse.
Saline Nasal Sprays such as Ocean or Ayr help to clean out your nasal passages and help clear congestion.
Of course, each of these medications has its advantages and disadvantages (side effects), which your doctor will discuss with you.
Since most cases of acute sinusitis (98%) are caused by a virus and not bacteria, they are usually not treated with antibiotics.
In prescribing antibiotics for acute bacterial sinusitis, your doctor may base the choice of antibiotic on many factors, including:
- Type of bacteria causing the infection
- Result of sinus cultures used to guide treatment
- Resistance of the bacteria to certain antibiotics
- Medication allergies you may have
- Other medications you are taking
- Other medical conditions you may have
- Previous treatments you may have undergone
Oral Antibiotics such as Amoxicillin treat bacterial infections like acute rhinosinusitis and is usually prescribed for 10-14 days. For chronic sinusitis, the treatment is a bit more complicated, as it requires a more prolonged duration of medical therapy (a combination of medications as discussed above). The choice of antibiotic often depends on the result of sinus cultures (a test that uses a sample of a patient’s mucus to determine which bacteria are present), and once prescribed, your doctor will have you take it for 3-4 weeks time.
Whether you have acute or chronic rhinosinusitis, your doctor will want to follow up with you in a few weeks after starting treatment to see how the medication is working to alleviate your symptoms.