Sinus Infections

What antibiotic is best for sinus infection?

Answer

Wiki User
01/04/2011

Sinusitis is not a simple matter-- not a thing to simply be cured or

not by the right antibiotic (although it is sometimes that simple).

Bacteria grow in sinuses not draining correctly, and the question is

why they aren't? Anatomical problems, allergies, what? Then there is

the problem that chronic sinus infections cause their own damage, and

tend to be mixed infections with anaerobes and even fungi.

Finally, there is the problem that there are many things not known

about this area. For instance, I've seen two people on high dose IV

mega antibiotics for hospital infections, who were also as a side

effect "cured" of nearly life long "seasonal allergies" thereby.

Apparently. What was going on there? I dunno.

If one has to treat chronic sinusitis with antibiotics alone, it's

probably best to try a regime with clindamycin in it, to get the

anaerobes, and metronidazole so the clinda doesn't cause C. difficile

for the 6 weeks you're going to be taking it. After that, it's a

tossup what broad-spectrum antibiotics to try, except that they need to

cover H. flu and strep and perhaps staph. Macrolides are not going to

be helpful if you're already using clindamycin, so Biaxin and Zithromax

are not great ideas. Augmentin or a fluoroquinolone can be used.

Rifampin is also sometimes very helpful as adjunct in getting at deep

seated infections with lots of pus (as in sinuses).

Quite often the main thing, however, is to see the ENT people about

drainage, and the allergy people about desensitization.

J.Fisher