Sinusitis Treatment

Sinusitis is inflammation of the sinus linings, usually triggered by infection, allergies, or blocked drainage. Acute sinusitis lasts under 4 weeks and most often follows a viral cold; bacterial sinusitis can develop when trapped mucus becomes infected. Chronic sinusitis (lasting more than 12 weeks) typically reflects persistent inflammation from allergies, nasal polyps, deviated septum, or other structural issues.

Viral sinusitis usually peaks in 3–5 days and improves within 7–10 days. Bacterial sinusitis is suspected when symptoms last more than 10 days without improvement, worsen after initial improvement ("double sickening"), or include severe facial pain, fever above 102°F, or persistent thick discolored discharge. A clinical assessment distinguishes between them.

Most acute sinusitis (roughly 90–98% of cases) is viral and antibiotics provide no benefit. Antibiotics are appropriate for confirmed or strongly suspected bacterial sinusitis — diagnosis based on symptom duration, severity, and pattern. Unnecessary antibiotic use contributes to resistance, GI side effects, and yeast infections.

Saline nasal irrigation (neti pot or squeeze bottle), warm compresses over the cheeks and forehead, steam inhalation, hydration, and adequate rest all help. OTC nasal corticosteroid sprays reduce inflammation; oral decongestants and decongestant nasal sprays provide short-term relief. Avoid using decongestant nasal sprays (oxymetazoline, phenylephrine) for more than 3 days to prevent rebound congestion.

Antibiotics (amoxicillin, amoxicillin-clavulanate, doxycycline) most commonly cause GI upset, diarrhea, or rash. Oral decongestants (pseudoephedrine) can raise blood pressure, heart rate, and cause insomnia. Nasal corticosteroid sprays (fluticasone, mometasone) are well tolerated long-term, with occasional nasal irritation or minor nosebleeds. Saline rinses have essentially no side effects when prepared with distilled or previously boiled water.