sinus infection and antibiotics duration

[Travelassie]

Originally Posted by Deserterer

That's the whole point of starting the thread. You should read it, and the links I posted about more recent thinking about duration of use and resistance. In short, longer may be worse, not better.



Already improvement after only 30 hours, very little or no bad smell and foul taste today and no afternoon headache. My congestion actually seemed worse for a while but now I think that's improving too. That also may have been rebound from using Afrin for 3 the last days. I think I've got it on the run.

That's great news.

[kettlepot]

I'm a strong supporter of flushes, saline rinses and Neti pots. However, these were only effective after I had surgery to open up my sinus portals.

[Deserterer]

Since I think my bacteria are on the run I think I'll wrap this up with some pertinent info fromIDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults

https://academic.oup.com/cid/article/54/8/e72/367144

They recommend waiting 10 days before beginning antibiotics for ABRS (which I did)

They recommend 5-7 days of antibiotics for uncomplicated cases in adults (which is what I'll do if things go well). This recommendation is only weakly supported, so other durations may be used. Worth noting they don't recommend any over the 5-7 day period though, and adverse effectc increase with longer duration. The 5-7 days was chosen as middle ground between the 3-5 days and 6-10 days in some literature.

and an interesting one: Neither topical nor oral decongestants and/or antihistamines are recommended as adjunctive treatment in patients with ABRS (strong, low-moderate). Apparently things like Afrin won't help in the long run and may increase inflammation.

Lots of other info there

[Deserterer]

Finished 8 days of antibiotics after 10 days of waiting to make sure it wasn't viral. I'm still gonna finish the last 2 days, but its not going to change things.

It did seem to improve some, I'm not getting headaches and the nasty smell is better, but its still here. Still very mild, just small amounts of yellow mucus from right sinus and that smell, although fainter than it was. Called the doc thinking he might prescribe a different antibiotic, but instead he says its probably viral.

But the whole point of waiting 10 days was to rule out viral, I thought. The saga goes on...dammit.

Found this: https://jtd.amegroups.com/article/view/21370/html

makes me think it may be the RSV. Both RSV patients in the above had little nasal congestion, same as me, and the infection started on Day 9 of the RSV infection. Mine started on about Day 10.

There are differences though too. They didn't get the chest congestion that I got from RSV. Anyway it gives me hope that it is viral and not a resistant bacteria