Are antibiotics always necessary to cure a sinus infection?

Mark Bianchi, M.D., is an assistant professor of surgery at Yale School of Medicine who specializes in allergies and sinus problems.  He writes:

“Sinus infections (sinusitis) can be either viral (i.e. a common cold or flu) or bacterial. Only the bacterial infections respond to antibiotics.

“The common cause of prolonged infection is swelling and sinus obstruction or blockage. Using decongestants either in pill form (Pseudofed) or topically in the form of a spray (Afrin or Neosynephrine) can help prevent a prolonged sinus infection. Use caution not to use decongestant sprays for more than a few days or they will make you worse. Sinus rinse and nasal steroid sprays may also be useful.

“Most sinusitis is related to a cold or flu virus and does not require antibiotics. If symptoms persist for more than 5 days or come on without other associated symptoms of a cold, or are particularly severe, consult a physician for consideration of antibiotic therapy.  People with allergies or structural abnormalities such as deviated septum (the wall between the two nasal cavities) are at increased risk for sinusitis.”

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