Can you use sulfamethoxazole for a sinus infection

Despite the use of antibiotics and selected adjunctive therapy, 10 to 25 percent of primary care patients continue to have symptoms. The office re-evaluation of these patients, two to three weeks after the first visit, should include a careful history and physical examination, and a single Waters view of the sinuses should be taken to confirm the diagnosis. Empiric therapy may include a two-week course of a second-line antibiotic Table 4.

Antibiotics appear to be of little benefit in the treatment of chronic sinusitis. Recurrent or chronic sinusitis often requires otolaryngology consultation. CT imaging of the osteomeatal complex followed by functional endoscopic sinus surgery FESS often successfully restores the physiology of sinus aeration and drainage. Between 80 and 90 percent of FESS patients experience significant improvement of symptoms.

In the era of antibiotic therapy and adequate access to primary care, major complications of sinusitis are rare. However, 75 percent of all orbital infections are the direct result of sinusitis. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Address correspondence to L.

Fagnan, M. Sam Jackson Park Rd. Reprints are not available from the author. Benson V, Marano MA. Current estimates from the National Health Interview Survey, Vital Health Stat. Trends in antimicrobial drug prescribing among office-based physicians in the United States. Bamberger DM. Antimicrobial treatment of sinusitis. Semin Respir Infect. Illness in the home: a study of 25, illnesses in a group of Cleveland families.

Wald ER. Sinusitis in children. N Engl J Med. Hinriksdottir I, Melen I. Allergic rhinitis and upper respiratory tract infections. Acta Otolaryngol Suppl. The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies.

J Allergy Clin Immunol. Winther B, Gwaltney JM. Therapeutic approach to sinusitis: anti-infectious therapy as the baseline of management. Otolaryngol Head Neck Surg. Sinusitis of the maxillary antrum. Evans KL. Diagnosis and management of sinusitis. Usual care and outcomes in patients with sinus complaints and normal results of sinus roentgenography.

Arch Fam Med. Berg O, Carenfelt C. Analysis of symptoms and clinical signs in the maxillary sinus empyema. Acta Otolaryngol. Etiology and antimicrobial therapy of acute maxillary sinusitis. J Infect Dis. Axelsson A, Runze U. Comparison of subjective and radiological findings during the course of acute maxillary sinusitis.

Ann Otol Rhinol Laryngol. The correlation between the radiological examination and the irrigation findings in maxillary sinusitis. Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination.

Ann Intern Med. Use of symptoms, signs, and blood tests to diagnose acute sinus infections in primary care: comparison with computed tomography. Fam Med.

Use of symptoms and signs to diagnose maxillary sinusitis in general practice: comparison with ultrasonography. Comparison between transillumination and the roetgenogram in diagnosing paranasal sinus disease. Sinusitis in children: current management. Ear Nose Throat J. Current diagnosis and management of sinusitis. J Gen Intern Medicine. Diagnosing sinusitis by X-ray: is a single Waters view accurate?

J Gen Intern Med. Acute sinusitis in children: is the Water's view sufficient? Blood and urine tests may be needed to check for unwanted effects. Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. This medicine may cause serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms DRESS , acute generalized exanthematous pustulosis AGEP , or acute febrile neutrophilic dermatosis AFND.

Check with your doctor if you have a skin rash, blistering, peeling, loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, white spots in the mouth or on the lips, black, tarry stools, chest pain, or painful or difficult urination. Check with your doctor right away if you have dark urine, clay-colored stools, stomach pain, or yellow eyes or skin.

These may be symptoms of a serious liver problem. This medicine, especially if you are receiving high doses or for a long period of time, may lower the number of platelets in your body, which are necessary for proper blood clotting. Because of this, you may bleed or get infections more easily. Talk with your doctor if you have black, tarry stools, bleeding gums, blood in urine or stools, pinpoint red spots on the skin, unusual bleeding or bruising.

This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop taking this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor. Check with your doctor right away if you or your child have stomach cramps, bloating, watery and severe diarrhea, which may also be bloody, nausea or vomiting, or unusual tiredness or weakness.

These may be symptoms of a serious intestinal infection. This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you or your child have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you use the medicine. This medicine may cause electrolyte problems, including high potassium in the blood hyperkalemia and low sodium in the blood hyponatremia.

Tell your doctor right away if you have confusion, weakness, muscle twitching, an irregular heartbeat, numbness or tingling in the hands, feet, or lips, or trouble breathing. This medicine may cause hypoglycemia low blood sugar in some patients.

Check with your doctor if you have anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty with concentrating, drowsiness, excessive hunger, headache, nausea, nervousness, rapid heartbeat, shakiness, or unusual tiredness or weakness.

Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine. Patients receiving anticonvulsant treatment medicines to prevent seizures may be at risk for a folate vitamin B9 deficiency, which may increase the risk for side effects. Accordingly, we do not recommend antibiotics for sinus symptoms that appear to be improving spontaneously within the first days.

If you abuse antibiotics now, we may not have any options left when you really need them! Bacterial antibiotic resistance is a significant problem in Richmond, Virginia, and throughout the United States.

Many of the common bacteria that can cause sinusitis carry a gene for antibiotic resistance that can be turned on in the presence of antibiotics.

After a few days of treatment, the gene becomes activated and can even travel between bacteria in a capsule called a plasmid , creating resistance among a large population of bacteria. If you are not responding to a course of antibiotics within days, you may have a resistant strain of bacteria.

Consult your physician for an examination and possible culture or DNA analysis of your sinuses. DNA analysis of sinus drainage allows us to identify the most dangerous resistant strains within 24 hours and to provide a complete analysis of all bacteria in your nose within 1 week.

Amoxicillin remains the drug of choice for acute, uncomplicated bacterial sinusitis. Amoxicillin is most effective when given frequently enough to sustain adequate levels in the infected tissue. While often prescribed twice daily, it is even more effective if taken in 3 or 4 divided doses.

Amoxicillin is typically prescribed for days at a time. While it is critical to finish the entire 10 day course of antibiotics when treating strep throat, there is evidence that shorter courses of treatment may be sufficient for most cases of sinusitis. Amoxicillin is closely related to the parent compound penicillin and should not be prescribed in patients who are penicillin allergic.

Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. Sulfamethoxazole and trimethoprim combination is best taken with a full glass 8 ounces of water.

Several additional glasses of water should be taken every day, unless otherwise directed by your doctor. Drinking extra water will help to prevent some unwanted effects eg, crystals in the urine. For patients taking the oral liquid, use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid. To help clear up your infection completely, keep using this medicine for the full time of treatment, even if you begin to feel better after a few days.

If you stop taking this medicine too soon, your symptoms may return. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label.