My Drugs & SymptomsDrugsDrugs By ConditionTreatments
  Drug Search

   
 
Sinus Infection quick look
This chart rates treatment options according to general effectiveness, ease of use, side effects and safety.
Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
First Choice
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Amoxicillin
(Amoxil, many others)
 

Good 
 
 
 
 
First choice. Effective. Inexpensive. Safe - if no allergies to Penicillin-type drugs.
Tell Me More...
  Close

Amoxicillin

Amoxicillin is the most frequently prescribed antibiotic for sinus infections. The limited study data that is available indicate that amoxicillin is as effective as the newer, more expensive antibiotics for uncomplicated sinusitis.

Approximately 4% of individuals treated with amoxicillin develop side effects.

Those who have been allergic to amoxicillin in the past or who are allergic to penicillin drugs (including ampicillin or augmentin) should not take amoxicillin.

Amoxicillin is sometimes prescribed in high doses when sinusitis fails to improve with lower doses.

 
Ten-Day Course of Antibiotics  

Good 
 
 
 
 
Ten-day course most commonly prescribed. Limited information about optimal treatment duration.
Tell Me More...
  Close

Ten-Day Course of Antibiotics

Most studies have evaluated the effectiveness of antibiotics for treating sinus infections based on a ten-day course of treatment. Very little information is available about the most effective treatment duration.

Some studies have suggested that shorter durations may be effective, but there is concern that shorter courses which don't entirely eliminate bacteria may allow bacteria to develop resistance to antibiotics, making the infection much harder to treat.

Often, individuals with sinus infections do not fully recover with a ten day course, and as long as 3-4 weeks of antibiotics may be prescribed.

 
TMP-SMX
(trimethoprim/sulfamethoxazole, Bactrim-DS, Septra-DS)
 

Fair 
 
 
 
 
First choice. Effective. Inexpensive. An alternative for patients who are allergic to amoxicillin.
Tell Me More...
  Close

TMP-SMX

TMP-SMX is frequently prescribed for individuals with sinus infections. Limited study data indicates that it is as effective as amoxicillin for most people and, like amoxicillin, is inexpensive compared to other drugs.

Some experts recommend combining another antibiotic with TMP-SMX such as Keflex, especially in areas where the bacteria that causes sinusitis has become resistant to treatment with TMP-SMX.

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Other Options
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
amoxicillin/clavulanic acid
(Augmentin)
 

Good 
 
 
 
 
Effective. Expensive. Often used when other antibiotics fail to cure infection.
Tell Me More...
  Close

amoxicillin/clavulanic acid

Augmentin is much more expensive than amoxicillin and, according to the limited available data, is not significantly more effective than amoxicillin for treating uncomplicated sinus infections.

Augmentin is often used, however, when amoxicillin or TMP-SMX (trimethoprim/sulfamethoxazole) fail to cure a sinus infection.

 
Cephalosporin Antibiotics
(Ceftin/cefuroxime, Vantin/cefpodoxime, Cefzil/cefprozil, Omnicef/cefdinir, Ceclor/cefaclor, Lorabid/loracarbef, Suprax/cefixime)
 

Fair 
 
 
 
 
Effective. Sometimes used when other antibiotics fail. Should not be used for individuals who are allergic to penicillin-type drugs (including amoxicillin, ampicillin, more).
Tell Me More...
  Close

Cephalosporin Antibiotics

There are a number of cephalosporin drugs (Ceftin/cefuroxime; Vantin/cefpodoxime; Cefzil/cefprozil; Omnicef/cefdinir; Ceclor/cefaclor; Lorabid/loracarbef; Suprax/cefixime), each with somewhat different effectiveness against different kinds of bacteria.

Cephalosporin drugs are sometimes used when first choice drugs fail to cure a sinus infection, or in geographic areas where bacteria are resistance to first choice antibiotics.

These antibiotics are not typically recommended for individuals with penicillin allergies (penicillin, amoxicillin, ampicillin, more) Ten percent of those who are allergic to penicillin-type drugs (amoxicillin, ampicillin, augmentin, penicillin, more) are also allergic to cephalosporins.

 
Erythromycin-Type of Antibiotics
(erythromycin, Biaxin/clarithromycin ,Zithromax (Z-pak)/azithromycin)
 

Fair 
 
 
 
 
Effective. Used for treatment failures and penicillin/amoxicillin allergies.
Tell Me More...
  Close

Erythromycin-Type of Antibiotics

Erythromycin-type of antibiotics (erythromycin, Biaxin/clarithromycin, Zithromax(Z-Pak)/azithromycin) are used when other antibiotics fail, or for patients who are allergic to penicillin-type drugs (ampicillin, amoxicillin, more).

 
Quinolone Antibiotics
(Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin, others)
 

Fair 
 
 
 
 
Limited data about effectiveness.
Tell Me More...
  Close

Quinolone Antibiotics

Quinolone antibiotics have been used for some individuals with sinusitis.

There is some concern that two of the Quinilone antibiotics - Tequin and Avelox - might cause a heart-related side effect (called QT prolongation) that increases the risk of the heart stopping suddenly ("Sudden Death") Tequin has been withdrawn from the market. Do NOT use any leftover Tequin that you might have on hand.

Quinolone antibiotics are not recommended for children (younger than 18 years old) or pregnant women.

 
Pain-Relief Medications
(Tylenol/acetaminophen, Advil or Motrin/ibuprofen, more)
 

Not available 
 
 
 
 
For symptom relief. No known benefit for curing the infection.
Tell Me More...
  Close

Pain-Relief Medications

Pain cause by sinus infections can be severe. Most clinicians recommend the use of over-the-counter pain relief medications for 1-3 days.

Studies have suggested that symptoms caused by bacterial sinusitis tend to be relieved after 1-3 days of antibiotics. Pain treatment should not be necessary after this period of time if the antibiotics are working.

 
Cleocin/clindamycin  

Not available 
 
 
 
 
Effective. Expensive. May be used for infections in which amoxicillin is not effective.
Tell Me More...
  Close

Cleocin/clindamycin

Clindamycin is another option that can be used when the sinusitis-causing bacteria is resistant to (not vulnerable to) amoxicillin and related antibiotics. Side effects, including serious forms of diarrhea, can be severe, and it should not generally be used if other alternatives are available.

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Not Recommended
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Steroid Pills
(Prednisone, Decadron, Medrol dosepack, many others)
 

Very poor 
 
 
 
 
No proven benefit. Significant side effects.
Tell Me More...
  Close

Steroid Pills

There is no evidence to show that steroids pills are beneficial for treating sinus infections. Given the frequency and severity of side effects, most experts recommend against using them for sinusitis, except in unusual circumstances.

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Insufficient Data
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Salt water Irrigation  

Not available 
 
 
 
 
No data about effectiveness. May improve nasal congestion.
Tell Me More...
  Close

Salt water Irrigation

Several guidelines recommend the use of this treatment to improve the symptom of nasal congestion.

Approximately 1/4 teaspoon of salt is dissolved in 1 cup of water and a bulb syringe or dropper (that can be purchased from a drugstore) is used to squirt water up into the nose.

 
Decongestants
(Sudafed/pseudoephedrine , Afrin/oxymetazoline, others)
 

Not available 
 
 
 
 
Limited data. Experts believe decongestants may be helpful. Nasal spray may be safer for some patients than pills.
Tell Me More...
  Close

Decongestants

Although there is a lack of scientific data, many experts believe that decongestants are a useful addition to sinusitis treatment. They can improve symptoms of nasal congestion and, in theory, may improve nasal drainage which could help with the elimination of infection-causing bacteria.

Decongestants are available as pills (e.g. Sudafed) and as nasal sprays (e.g. Afrin). Decongestant pills should be used with caution in individuals with heart disease, glaucoma, an enlarged prostate gland, or diabetes. Because Sudafed has potential use in the illicit manufacturing of methamphetamine (speed), pharmacies must maintain a registry of who buys it; you will need to sign a register at the pharmacy to buy the over-the- counter drugs that still contain sudafed.

An over-the-counter decongestant that was widely used at one time, phenylpropanolamine (PPA), has caused serious problems, including strokes and extremely high blood pressure, and has been removed from the US market by the FDA. Any leftover medicines that may contain it should be discarded.

Nasal spray decongestant (e.g. Afrin) should not be used for more than 3 days. Longer use can cause a condition called atrophic rhinitis (an inflammation of the lining of the nasal cavity).

 
Antihistamines
(Claritin/loratadine, Allegra/fexofenidine, Zyrtec/cetirizine, Astelin/azelastine nasal spray, more))
 

Not available 
 
 
 
 
Limited data available. May be useful for some people who have allergy symptoms along with their sinusitis. Controversy about usefulness for individuals with sinusitis who do not have allergies.
Tell Me More...
  Close

Antihistamines

Little scientific data is available about whether or not antihistamines are helpful for individuals with sinusitis. Some experts believe that they may be helpful for those who have allergies (by decreasing nasal congestion and allowing better nasal drainage).

There is some question about whether antihistamines can worsen sinus infections in those who do not have allergies. Since these medicines tend to dry out the nasal passages, theoretically, their use could create a thick, dry mucus that does not drain easily and that provides a good place for bacteria to multiply.

 
Expectorants
(Robitussin/guaifenesin, many others)
 

Not available 
 
 
 
 
Often recommended. No data regarding effectiveness.
Tell Me More...
  Close

Expectorants

Expectorants are often used as cough medicines. They increase mucus secretions in the nose (and airways) and some experts believe that this might help loosen nasal secretions and improve drainage in individuals with congested sinuses.

 
Inhaled Nasal Steroids
(Beconase/beclomethasone, Flonase/fluticasone, Nasacort/triamcinolone, Rhinocort/budesonide/, Nasalide/flunisolide, Nasonex/mometasone, others)
 

Not available 
 
 
 
 
No data regarding effectiveness. Theoretically may be beneficial for some patients with allergy-related sinusitis that recurs frequently.
Tell Me More...
  Close

Inhaled Nasal Steroids

Studies are necessary to evaluate the effectiveness of this treatment.

 
Adequate Fluids
(Avoiding dehydration)
 

Not available 
 
 
 
 
No available data. In theory, helps loosen nasal secretions and promotes drainage. Some guidelines recommend 6-10 glasses of liquid a day.
Tell Me More...
  Close

Adequate Fluids

Bacteria tend to grow best in stagnant and thick fluid. Drinking enough fluids theoretically helps to loosen the nasal secretions and allow them to flush out the bacteria.

 
Steamy Showers/Steam Inhalation  

Not available 
 
 
 
 
No available data about effectiveness. Recommended by experts for symptom relief.
Tell Me More...
  Close

Steamy Showers/Steam Inhalation

Some experts believe that steam from a hot bathtub or shower helps to loosen nasal secretions and relieve congestion.

Inhaling steam from a pot of hot water (with a towel placed over the head to make a steam tent) has also been recommended. Care must be taken to avoid burns when using any of these methods. (Remove hot water from the stove before use and inhale for short periods of time).

Because burns have occurred with steam vaporizers, and because bacteria and fungus often grow inside of them, vaporizers are not currently recommended.

 
Warm Packs to Face  

Not available 
 
 
 
 
No available data about effectiveness. Recommended by experts for symptom relief.
Tell Me More...
  Close

Warm Packs to Face

Some experts believe that applying warm packs to the face will increase the blood flow to the sinuses and increase the presence of bacteria-fighting immune cells.

Care should be taken to prevent burns from a pack that is too hot or is left on for too long (avoid falling asleep with the pack).

One national guideline recommends a warm wash cloth, hot water bottle, or gel pack for 5-10 minutes, 3 or more times a day.

 
Salt Water Nasal Spray/Drops  

Not available 
 
 
 
 
No available data about effectiveness. Recommended by experts for symptom relief.
Tell Me More...
  Close

Salt Water Nasal Spray/Drops

Theoretically helps to loosen the nasal secretions and allow them to flush out the bacteria.

 
Over-the-Counter nasal drops/sprays
(Ocean, Salinex, Nasal)
 

Not available 
 
 
 
 
No available data about effectiveness. Sometimes recommended by physicians for symptom relief.
Tell Me More...
  Close

Over-the-Counter nasal drops/sprays

Over-the-counter salt water drops or nasal sprays can be purchased at a local drugstore.

 

 
     
NOTE: Just because a drug or combination of drugs can cause a symptom does not mean it is actually causing your symptom. Symptoms can be caused by medical conditions as well. Make sure that your physician is aware of any symptoms you are experiencing so he/she can work with you to determine the cause. Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
DISCLAIMER: Please note that the information DoubleCheckMD.com provides is intended to help individuals to work with their medical professionals and is for educational purposes only. It does not constitute medical or healthcare advice and serves to supplement, not substitute for, the expertise and judgment of a healthcare professional. In all cases individuals should consult with a physician before taking any action based on DoubleCheckMD feedback including, but not limited to ceasing taking any drug, changing diet or commencing or discontinuing any course of treatment. The information provided by DoubleCheckMD.com is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that the use of a particular drug is safe, appropriate or effective.


 
 
Username
Password
 
Forgot Password Log into DoubleCheckMD
 
 
 
Email Address
 
 
 
 
 
 
We'll keep Your Personal Information Private

Registration helps ensure the privacy of your personal health information. It's easy to register. Just enter a username and password. This is information you will use to login so you may want to write it down.
Username*
Password*
Password* (verify)
First Name (optional)
Last Name (optional)
Email Address (optional)
I have read and agree to abide by the DoubleCheckMD Terms of Use and DoubleCheckMD Privacy Policy.
I am a medical professional
 
Register
 
 
First name
Last name
Email Address
Comments*
 
 
 
First name
Last name
Email Address
Comments*
 
 
 
 
 
 
 
 
 
 
 
 
Close
HOLDER
 
 
Close
HOLDER
 
     
 
 
     
     
 
Close
HOLDER