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Home Knowledge Center Wellness Library Sinusitis: Should I Take Antibiotics?

Sinusitis: Should I Take Antibiotics?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Sinusitis: Should I Take Antibiotics?

Get the facts

Your options

  • Take antibiotics to treat acute (short-term)sinusitis.
  • Don't take antibiotics. Try other medicines and home treatment instead.

Key points to remember

  • Sinusitis is inflammation of the mucous membranes inside the nose and sinuses. Sinuses are the hollow spaces in your skull around the eyes and nose. Most people who get acute sinusitis have a cold first.
  • Acute sinusitis usually goes away on its own.
  • Sinusitis is usually caused by a virus, so antibiotics won't help. Over-the-counter medicines and home treatment can help you feel better.
  • Antibiotics do work if sinusitis is caused by bacteria. But you may not need to take them. Most people get better even if they don't take antibiotics.
  • Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance.
  • Antibiotics have side effects. The most common ones include upset stomach, diarrhea, and belly pain. Antibiotics can also lead to vaginal yeast infections.
FAQs

What is sinusitis?

Sinusitis is an inflammation of the mucous membranes inside the nose and sinuses. Sinuses are the hollow spaces in your skull around the eyes and nose. Most of the time, acute sinusitis is caused by a virus. But it can also be caused by bacteria. Most people who get acute sinusitis have a cold first. Sinusitis can cause pain and pressure in your head and face along with a stuffy or blocked nose. Symptoms may also include thick, discolored drainage from the nose or down the back of the throat.

There are two types of sinusitis:

  • Acute (short-term). Acute sinusitis is usually caused by a virus. It can last for 2 to 4 weeks. Symptoms often start to clear up on their own in 7 to 14 days.
  • Chronic (long-term). Chronic sinusitis is caused by long-term swelling of the sinuses. Anything that causes the mucous membranes to become inflamed and stay inflamed may lead to chronic sinusitis. This includes allergies and nasal polyps. A deviated nasal septum can also make it worse. Chronic sinusitis can last for 12 weeks or longer. It can be hard to treat.

How is sinusitis treated?

Your treatment will depend on the cause and type of your sinusitis. Most of the time, treatment includes medicines and taking care of yourself at home. Here are some common treatments for acute and chronic sinusitis.

Acute Sinusitis

  • Nasal washes. These help keep your nasal passages open and wash out mucus and allergens.
  • Over-the-counter pain medicine. These include a decongestant like oxymetazoline (for example, Afrin) or a pain reliever like acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil).
  • Nasal steroids. These help reduce swelling of the mucous membranes.
  • Antibiotics. These kill bacteria. Antibiotics will only work if your sinusitis is caused by bacteria. Most of the time, acute sinusitis is caused by a virus.

Chronic Sinusitis

  • Nasal washes.
  • Nasal steroids.
  • Allergy medicines.
  • Surgery, if symptoms can't be controlled by medicines and home treatment.

How do you know if your sinusitis is caused by bacteria?

You may have a bacterial infection in your sinuses if:

  • You have symptoms of acute sinusitis and you have not started to get better after 10 days.

OR

  • Your symptoms get worse after they had been getting better within 10 days of the symptoms starting. This is called double-worsening.

How well do antibiotics work for sinusitis?

Antibiotics work in most cases of acute sinusitis that are caused by bacteria. Many people start feeling better 3 to 4 days after they start taking the medicine.

Antibiotics won't work for infections caused by a virus. Over-the-counter medicines and home treatment can help you feel better.

What are the risks of antibiotics?

Taking antibiotics you don't need won't help you feel better, cure your infection, or keep you from passing the infection on to someone else. And if you take antibiotics too often, they may not work when you really do need them.

Common side effects of antibiotics include:

  • An upset stomach.
  • Diarrhea.
  • Belly pain.
  • Vaginal yeast infections.

If you do take antibiotics, take them as directed. Keep taking them even after you start to feel better. The infection may not go away if you don't take all of the medicine your doctor prescribes.

How can you treat acute sinusitis without antibiotics?

Whether sinusitis is caused by bacteria or by a virus, most people get better even if they don't take antibiotics.footnote 1 Home treatment for sinusitis can help relieve your symptoms. Here are some things you can do:

  • Use saline (saltwater) nasal washes to help keep your nasal passages open and to wash out mucus and allergens. You can buy saline nasal washes at a grocery store or drugstore. Or you can make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled.
  • Drink plenty of fluids to thin your mucus.
  • Ask your doctor if you can take over-the-counter medicines such as pain relievers and decongestants to help you feel better. Be safe with medicines. Read and follow all instructions on the label.
  • Breathe warm, moist air. You can use a steamy shower, a hot bath, or a sink filled with hot water.

Why might your doctor recommend antibiotics for sinusitis?

Your doctor may recommend antibiotics if:

  • You have symptoms of acute sinusitis and you have not started to get better after 10 days, even with home treatment.
  • Your symptoms start to get better within 10 days but then get worse again.
  • You have chronic sinusitis, and your sinusitis symptoms get worse for more than 7 to 10 days without getting better.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take antibiotics to treat acute sinusitis Take antibiotics to treat acute sinusitis
  • You take antibiotics to kill a bacterial infection.
  • You may need to take a different antibiotic if the first one doesn't work.
  • You may also take other medicines to help drain your sinuses.
  • If your sinusitis is caused by bacteria, you may start to feel better in 3 to 4 days.
  • Antibiotics work well for bacterial infections.
  • Side effects of antibiotics include belly pain, upset stomach, diarrhea, and vaginal yeast infection.
  • Taking antibiotics you don't need won't help you feel better, cure your infection, or keep you from passing the infection on to someone else.
  • If you take antibiotics too often, the medicine may not work the next time you take it when you really do need it.
Don't take antibiotics Don't take antibiotics
  • You use over-the-counter medicines such as pain relievers and decongestants to feel better.
  • You try home treatment, such as:
    • Trying saline (saltwater) nasal washes.
    • Drinking plenty of fluids.
    • Breathing warm, moist air from a steamy shower or hot bath.
  • Most people get better on their own in 7 to 14 days.
  • You avoid the risks of antibiotics.
  • Your sinus infection may not get better on its own.
  • Your sinus infection may get worse.

Personal stories about antibiotics for sinusitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I've had sinusitis a few times. So when my doctor suggested I take an antibiotic, I asked him if I really needed it. He said I would probably get better faster if I took the medicine. But I know from the other times that I'll probably be okay in a week or so anyway. So we decided to wait and see instead of trying antibiotics.

Maria, age 34

I can't wait to feel better. It seems like I've had bad sinus pain for the longest time. It's been at least 2 weeks. Nasal sprays aren't helping. I'm going to ask my doctor for antibiotics.

David, 28

I thought I just had a bad cold, but my doctor says I have sinusitis caused by a bacterial infection. I've been doing all the right things at home, but it isn't going away. I think antibiotics are the next step for me.

Carmen, 50

I thought I'd get my doctor to give me some antibiotics for my sinusitis. Then I'd be over it sooner. But since it's been a week since my symptoms began and I'm already starting to feel better, my doctor says I don't need to take an antibiotic unless I start to feel worse. I'm going to wait it out instead.

John, age 52

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics for acute sinusitis

Reasons not to take antibiotics

I know I have a bacterial infection that is causing my sinusitis.

A virus is causing my sinusitis.

More important
Equally important
More important

I've tried home treatment, but it has not helped.

I want to try home treatment and other medicines first.

More important
Equally important
More important

The side effects of antibiotics don't bother me.

I'm worried about the side effects of antibiotics.

More important
Equally important
More important

I want to take medicine if it will help me get better faster.

I don't want to take medicine that I might not need if I'll get better soon anyway.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antibiotics

NOT taking antibiotics

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Is acute sinusitis most often caused by a virus?
2, Is it okay to take antibiotics anytime you think they might help, even if you may not really need them?
3, Can antibiotics treat acute sinusitis that is caused by bacteria?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
2, Check what you need to do before you make this decision.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Print Summary

Credits and References

Credits
Author Healthwise Staff
Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
References
Citations
  1. Rosenfeld R, et al. (2015). Clinical practice guideline (updated): Adult sinusitis. Otolaryngology–Head and Neck Surgery, 152(2S): S1–S39. DOI: 10.1177/0194599815572097. Accessed December 14, 2021.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Sinusitis: Should I Take Antibiotics?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Take antibiotics to treat acute (short-term)sinusitis.
  • Don't take antibiotics. Try other medicines and home treatment instead.

Key points to remember

  • Sinusitis is inflammation of the mucous membranes inside the nose and sinuses. Sinuses are the hollow spaces in your skull around the eyes and nose. Most people who get acute sinusitis have a cold first.
  • Acute sinusitis usually goes away on its own.
  • Sinusitis is usually caused by a virus, so antibiotics won't help. Over-the-counter medicines and home treatment can help you feel better.
  • Antibiotics do work if sinusitis is caused by bacteria. But you may not need to take them. Most people get better even if they don't take antibiotics.
  • Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it. This is called antibiotic resistance.
  • Antibiotics have side effects. The most common ones include upset stomach, diarrhea, and belly pain. Antibiotics can also lead to vaginal yeast infections.
FAQs

What is sinusitis?

Sinusitis is an inflammation of the mucous membranes inside the nose and sinuses. Sinuses are the hollow spaces in your skull around the eyes and nose. Most of the time, acute sinusitis is caused by a virus. But it can also be caused by bacteria. Most people who get acute sinusitis have a cold first. Sinusitis can cause pain and pressure in your head and face along with a stuffy or blocked nose. Symptoms may also include thick, discolored drainage from the nose or down the back of the throat.

There are two types of sinusitis:

  • Acute (short-term). Acute sinusitis is usually caused by a virus. It can last for 2 to 4 weeks. Symptoms often start to clear up on their own in 7 to 14 days.
  • Chronic (long-term). Chronic sinusitis is caused by long-term swelling of the sinuses. Anything that causes the mucous membranes to become inflamed and stay inflamed may lead to chronic sinusitis. This includes allergies and nasal polyps. A deviated nasal septum can also make it worse. Chronic sinusitis can last for 12 weeks or longer. It can be hard to treat.

How is sinusitis treated?

Your treatment will depend on the cause and type of your sinusitis. Most of the time, treatment includes medicines and taking care of yourself at home. Here are some common treatments for acute and chronic sinusitis.

Acute Sinusitis

  • Nasal washes. These help keep your nasal passages open and wash out mucus and allergens.
  • Over-the-counter pain medicine. These include a decongestant like oxymetazoline (for example, Afrin) or a pain reliever like acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil).
  • Nasal steroids. These help reduce swelling of the mucous membranes.
  • Antibiotics. These kill bacteria. Antibiotics will only work if your sinusitis is caused by bacteria. Most of the time, acute sinusitis is caused by a virus.

Chronic Sinusitis

  • Nasal washes.
  • Nasal steroids.
  • Allergy medicines.
  • Surgery, if symptoms can't be controlled by medicines and home treatment.

How do you know if your sinusitis is caused by bacteria?

You may have a bacterial infection in your sinuses if:

  • You have symptoms of acute sinusitis and you have not started to get better after 10 days.

OR

  • Your symptoms get worse after they had been getting better within 10 days of the symptoms starting. This is called double-worsening.

How well do antibiotics work for sinusitis?

Antibiotics work in most cases of acute sinusitis that are caused by bacteria. Many people start feeling better 3 to 4 days after they start taking the medicine.

Antibiotics won't work for infections caused by a virus. Over-the-counter medicines and home treatment can help you feel better.

What are the risks of antibiotics?

Taking antibiotics you don't need won't help you feel better, cure your infection, or keep you from passing the infection on to someone else. And if you take antibiotics too often, they may not work when you really do need them.

Common side effects of antibiotics include:

  • An upset stomach.
  • Diarrhea.
  • Belly pain.
  • Vaginal yeast infections.

If you do take antibiotics, take them as directed. Keep taking them even after you start to feel better. The infection may not go away if you don't take all of the medicine your doctor prescribes.

How can you treat acute sinusitis without antibiotics?

Whether sinusitis is caused by bacteria or by a virus, most people get better even if they don't take antibiotics.1 Home treatment for sinusitis can help relieve your symptoms. Here are some things you can do:

  • Use saline (saltwater) nasal washes to help keep your nasal passages open and to wash out mucus and allergens. You can buy saline nasal washes at a grocery store or drugstore. Or you can make your own saline solution at home. If you make saline at home, use distilled water or water that has been boiled and then cooled.
  • Drink plenty of fluids to thin your mucus.
  • Ask your doctor if you can take over-the-counter medicines such as pain relievers and decongestants to help you feel better. Be safe with medicines. Read and follow all instructions on the label.
  • Breathe warm, moist air. You can use a steamy shower, a hot bath, or a sink filled with hot water.

Why might your doctor recommend antibiotics for sinusitis?

Your doctor may recommend antibiotics if:

  • You have symptoms of acute sinusitis and you have not started to get better after 10 days, even with home treatment.
  • Your symptoms start to get better within 10 days but then get worse again.
  • You have chronic sinusitis, and your sinusitis symptoms get worse for more than 7 to 10 days without getting better.

2. Compare your options

Take antibiotics to treat acute sinusitis Don't take antibiotics
What is usually involved?
  • You take antibiotics to kill a bacterial infection.
  • You may need to take a different antibiotic if the first one doesn't work.
  • You may also take other medicines to help drain your sinuses.
  • You use over-the-counter medicines such as pain relievers and decongestants to feel better.
  • You try home treatment, such as:
    • Trying saline (saltwater) nasal washes.
    • Drinking plenty of fluids.
    • Breathing warm, moist air from a steamy shower or hot bath.
What are the benefits?
  • If your sinusitis is caused by bacteria, you may start to feel better in 3 to 4 days.
  • Antibiotics work well for bacterial infections.
  • Most people get better on their own in 7 to 14 days.
  • You avoid the risks of antibiotics.
What are the risks and side effects?
  • Side effects of antibiotics include belly pain, upset stomach, diarrhea, and vaginal yeast infection.
  • Taking antibiotics you don't need won't help you feel better, cure your infection, or keep you from passing the infection on to someone else.
  • If you take antibiotics too often, the medicine may not work the next time you take it when you really do need it.
  • Your sinus infection may not get better on its own.
  • Your sinus infection may get worse.

Personal stories

Personal stories about antibiotics for sinusitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I've had sinusitis a few times. So when my doctor suggested I take an antibiotic, I asked him if I really needed it. He said I would probably get better faster if I took the medicine. But I know from the other times that I'll probably be okay in a week or so anyway. So we decided to wait and see instead of trying antibiotics."

— Maria, age 34

"I can't wait to feel better. It seems like I've had bad sinus pain for the longest time. It's been at least 2 weeks. Nasal sprays aren't helping. I'm going to ask my doctor for antibiotics."

— David, 28

"I thought I just had a bad cold, but my doctor says I have sinusitis caused by a bacterial infection. I've been doing all the right things at home, but it isn't going away. I think antibiotics are the next step for me."

— Carmen, 50

"I thought I'd get my doctor to give me some antibiotics for my sinusitis. Then I'd be over it sooner. But since it's been a week since my symptoms began and I'm already starting to feel better, my doctor says I don't need to take an antibiotic unless I start to feel worse. I'm going to wait it out instead."

— John, age 52

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics for acute sinusitis

Reasons not to take antibiotics

I know I have a bacterial infection that is causing my sinusitis.

A virus is causing my sinusitis.

More important
Equally important
More important

I've tried home treatment, but it has not helped.

I want to try home treatment and other medicines first.

More important
Equally important
More important

The side effects of antibiotics don't bother me.

I'm worried about the side effects of antibiotics.

More important
Equally important
More important

I want to take medicine if it will help me get better faster.

I don't want to take medicine that I might not need if I'll get better soon anyway.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking antibiotics

NOT taking antibiotics

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Is acute sinusitis most often caused by a virus?

  • Yes
  • No
  • I'm not sure
You're right. Most of the time, acute sinusitis is caused by a virus, and antibiotics don't work against a virus.

2. Is it okay to take antibiotics anytime you think they might help, even if you may not really need them?

  • Yes
  • No
  • I'm not sure
You're right. Taking antibiotics too often or when you don't need them can be harmful. The medicine may not work the next time you take it when you really do need it.

3. Can antibiotics treat acute sinusitis that is caused by bacteria?

  • Yes
  • No
  • I'm not sure
You're right. Antibiotics can treat acute sinusitis when it's caused by bacteria. But many people get better even without antibiotics.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.
Credits
By Healthwise Staff
Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
References
Citations
  1. Rosenfeld R, et al. (2015). Clinical practice guideline (updated): Adult sinusitis. Otolaryngology–Head and Neck Surgery, 152(2S): S1–S39. DOI: 10.1177/0194599815572097. Accessed December 14, 2021.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

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