Antibiotics not the first choice for sinusitis

September 5, 2012 by
Filed under: Research, Spinewave Bulletin 

According to US Pharmacist, bacteria causes sinusitis in only 2% to 10% of cases, yet a recent national survey showed that 81% of adults presenting with acute sinusitis were prescribed antibiotics.

Viral and bacterial sinusitis present nearly identical symptoms, making it difficult to differentiate between the two, yet GPs prescribe antibiotics as a matter of course. Not only do bacteria become drug-resistant if it were a bacterial infection, according to the new guidelines put out by the Infectious Diseases Society of America this year, but antibiotics can also have a long term damaging effect on the natural infection-fighting flora of the gut.

The bottom line is that because 90% of sinusitis is viral in nature, the treatment is “symptomatic control”, as shown in the diagram (drugs to make you feel better). However, an acute bacterial infection would present for longer than 10 days, possibly have fever, facial pain, headache and purulent nasal discharge. There is no difference between an antibiotic treatment course of 3, 7 or 10 days, so if you felt obligated to take a course of antibiotics, opt for the shortest one because most sinus infections are “self limiting” anyway – meaning the body will heal itself.

There is actually no recommended medical course of action for chronic sinusitis lasting longer than 12 weeks besides sending the individual off for scans or doing surgical sinus drains, so there is no point in continuously taking antibiotics. Again, this will only cause long term damage to the immune system. At this point patients usually find themselves on a combination of nasal sprays, antihistamines, decongestants, corticosteroids or daily nasal rinses.

The guidelines recommend looking at alternative treatments and one very powerful tool is upper cervical chiropractic care. The upper cervical spine has an intimate relationship with the function of the sinuses and lymph drainage around the neck. Tiny misalignments of the upper neck can cause a disruption of these natural drainage mechanisms. One client had suffered with sinus problems for 20 years before her first adjustment:

Within a couple of weeks, I noticed my sinus problems had dissipated. I stopped using my nasal spray and also stopped taking the antihistamine tablets. Apart from a couple of minor sinus attacks since February, I have had no problems even though I am no longer using or taking any drugs. Previously, I was suffering from sinus on a day to day basis… read more.

Some conditions that present similarly to sinusitis warrant urgent referral due to possible complications, like brain and eye infections. Symptoms that indicate urgent referral are double vision, blindness, change in mental status, and lots of swelling around the eyes.

Reference: US Pharmacist. 2012;37(7):27-30.

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