Antibiotics for Sinus Infection

When to Use and Avoid Antibiotics and Other Treatments to Try

A sinus infection can be treated with antibiotics when it is caused by bacteria. Sinus infections that have other causes, such as allergies or viruses, won't benefit from antibiotics.

Most sinus infections don't need antibiotics and will start to get better without treatment. Healthcare providers typically only prescribe antibiotics for sinus infections that don't clear up on their own.

This article looks at what types of sinus infections can be treated with antibiotics. It also discusses over-the-counter treatments and home remedies.

woman with sinus infection
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When Antibiotics Are Needed

Antibiotics can help eliminate bacterial sinus infections. But when a sinus infection is caused by allergies, a virus, or a structural defect of the sinuses, other treatments may be necessary.

Allergists and other specialists recommend limiting the use of antibiotics for situations when the symptoms seem to be caused by a bacterial infection.

This includes:

  • Symptoms lasting over seven to 10 days
  • A fever (which may indicate a bacterial infection) is present
  • Clear and definite signs of a bacterial infection, such as redness, swelling, or pus

Overuse and Resistance

Historically, sinus infections, also called sinusitis, were often treated with antibiotics. But today, healthcare providers warn against the nonselective use of antibiotics for a sinus infection.

The overuse of antibiotics is when they are prescribed for reasons other than when they are needed. Because of the common overprescribing of antibiotics for the type of sinus infections that do not warrant such treatment, many people have developed what’s commonly referred to as antibiotic resistance.

When Does Antibiotic Resistance Occur?

Antibiotic resistance means that certain drugs no longer work for a specific type of germ. This can occur when bacteria change in response to exposure to antibiotics so that the antibiotics no longer work efficiently against the bacteria. Antibiotic resistance develops In an individual's body, and then the contagious infection that is spread to other people In the community is also resistant.

Unfortunately, it's hard to know if a sinus infection is bacterial, viral, or has other causes based on symptoms alone. Because viral sinus infections tend to improve in 5 to 7 days, healthcare providers will sometimes only prescribe antibiotics if your symptoms go on for longer than this. A sinus infection that persists for longer than a week or continues to get worse during this time period is more likely to be bacterial.

Common Antibiotics for Sinus Infections

Antibiotics may be prescribed when symptoms of a sinus infection warrant such treatment. Common antibiotics for sinus infection include:

  • Augmentin (amoxicillin/clavulanate)
  • Zithromax (azithromycin)
  • Levaquin (levofloxacin): Although this drug is sometimes prescribed as a first line of therapy for sinusitis, it has serious side effects and should only be used as a last resort.
  • Septra (trimethoprim-sulfamethoxazole)
  • Amoxil (amoxicillin)

Symptoms of a Sinus Infection

Symptoms of a sinus infection are caused by the blockage of sinuses, which are hollow air spaces in the nasal area. When your sinuses are inflamed, the area gets blocked with fluid, causing pain and in some cases, allowing bacteria to grow.

Common symptoms of a sinus infection include:

  • Sinus pain around the bridge of the nose or under the eyes
  • Pain in the upper jaw and teeth
  • Headaches around the forehead or temples that worsen in the morning after sinus drainage has collected all night
  • Postnasal drip
  • Nasal discharge that is not clear
  • Nasal congestion
  • Tenderness of the face
  • Coughing (at night after lying down or in the morning)
  • Hoarseness and sore throat
  • Fatigue
  • Halitosis
acute sinusitis symptoms

Over-the-Counter Treatments

Before prescribing an antibiotic, your healthcare provider may suggest an over-the-counter (OTC) treatment for a sinus infection.

These may include:

  • Nasal decongestants and antihistamines: There are several combination drugs available over the counter, but be sure to consult with your allergist, pharmacist, or healthcare provider before using these store-bought drugs.
  • Nasal decongestant sprays: These can help open sinuses and relieve symptoms on a short-term basis but should not be used for longer than a few days. Using a steroid nasal spray such as Nasacort or Flonase may help relieve nasal congestion without causing the rebound effect.
  • Allergy medications: These medications (such as Claritin or Zyrtec) may help when allergies are the underlying cause of sinusitis.
  • Nasal corticosteroid sprays: Nasal corticosteroid sprays aim to help prevent inflammation and swelling in the sinuses and nasal passages. These sprays can also help reduce existing swelling associated with sinus infections. One of the biggest advantages of using this type of nasal spray is that its use does not result in a rebound effect and is safer for long-term use than other types of nasal sprays.

Warning About Decongestants

Note that decongestants can help relieve nasal and sinus congestion but they are contraindicated (shouldn't be taken) if you have certain medical conditions, such as glaucoma or hypertension/high blood pressure.

Be sure to consult with your healthcare provider before using any type of OTC medication to treat a sinus headache, particularly if you take any type of medication or you have a medical condition.

Home Remedies

Saline nasal rinses are often used to help flush out thickened mucus and allergens from the nasal passages and to relieve dryness. Studies have shown that effective use of a low-pressure nasal saline rinse with high volume can lead to a rapid and long-term improvement in quality of life for people who have long-term sinus infections.

Be sure to consult with your allergist or another healthcare provider before using a saline nasal rinse.

Using the Right Water During Saline Rinses

When using saline nasal rinses, tap water should always be boiled and then allowed to cool to ensure cleanliness; distilled water or premixed solutions could also be used instead of regular tap water.

Other home remedies for sinus infections include:

  • Drinking fluids: Drinking lots of fluids helps loosen and thin mucus. Avoid beverages that are caffeinated (like coffee) and alcoholic beverages that can dehydrate the body, which could thicken mucus.
  • Breathing steam: Warm water is best (not too hot). You can breathe in steam from either a bowl or shower.
  • Humidifying the air: Use a cool air vaporizer or humidifier, particularly at night while sleeping.
  • Avoiding environmental substances: Avoid tobacco smoke and chlorinated water that can dry up the mucus membranes and exacerbate symptoms.
  • Implementing treatment measures: At the first sign of infection, use antihistamines and employ regular nasal rinses.

A Word From Verywell

Although antibiotics are not always warranted for sinus infections, there are some instances when they can be beneficial. If you have symptoms of a sinus infection, you may need to see your healthcare provider.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Sinus infection.

  2. KidsHealth from Nemours. What happens when antibiotics are overused?

  3. Centers for Disease Control and Prevention. Sinus infection (sinusitis).

  4. Egan M, Hickner J. Saline irrigation spells relief for sinusitis sufferersJ Fam Pract. 2009;58(1):29-32.

  5. Dehler, J. Allina Health. Ten home remedies to relieve sinus pain and pressure.

By Sherry Christiansen
Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research.