Medications for sinusitis - Causes, symptoms and treatment. MF.
Sinusitis or sinusitis - inflammation of the maxillary( maxillary) sinuses of the nose, the most frequent complication of acute rhinitis. This is an infectious disease, i.e. It develops when viruses or bacteria enter the body. From what microbe caused inflammation, and will depend on treatment. The predominant majority of acute sinusitis is viral, taking place against the background of ARVI or influenza.
Uncomplicated viral rhinosinusitis in typical cases lasts from 7 to 10 days, during which time the immune system independently cures the infection and recovers. Unlike acute viral rhinosinusitis, bacterial sinusitis lasts longer and harder, more often leads to complications. The probability of bacterial sinusitis increases from the 10th day from the onset of symptoms.
Drugs to reduce the symptoms of sinusitis
In light cases, their use is sufficient( usually with viral sinusitis).
1. Anesthetic preparations. They are used in the presence of pain syndrome, high temperature. As a rule, paracetamol, ibuprofen, is used. Assign a short course( 3-4 days) for 1 tab.2 times a day.
2. Local vasoconstrictor - nasal drops and sprays. Oxymetazoline( nasivin, nazole) - has the greatest duration of action( 12 hours).Used to reduce the stuffiness of the nose no more than 3 days. A number of studies have shown that they themselves can provoke inflammation, therefore it is not recommended to exceed the permissible duration of application.
3. Saline solutions - drops and sprays. Improve the outflow of nasal discharge, moisturize the mucous membrane, reduce congestion. You can safely use up to recovery.
Aqua Maris. Adults - 2-3 doses in each nasal passage 4-8 times a day.
Children up to a year - 2 drops in each nasal passage, children 1-7 years - 1-2 injections in each nasal passage 1-3 times a day, children 7-16 years - 2 injections in each nostril 4-6 times a day
Treatment of bacterial sinusitis
Antibacterial therapy of sinusitis
It is prescribed only for bacterial sinusitis. Antibiotics do not work for viruses. Such drugs occupy the main place in the treatment of bacterial inflammatory process, shorten the duration of the disease.
Indications for the prescription of antibacterial therapy:
- severe sinusitis( high fever, poor overall health, presence of fluid in the sinuses, etc.)
- concomitant diseases of the immune system( immunodeficiencies), cardiovascular, respiratory systems.
- prolonged( more than 7 days) persistence of symptoms or weighting of the disease.
Groups of antibiotics for the treatment of sinusitis
1. Semisynthetic penicillins( aminopenicillins).
Amoxicillin( hiconcil, amosin)
Flemoxin solutab
Tablets 125, 250, 500,1000 mg
2. "Protected" aminopenicillins. Contain special substances that prevent the destructive effects of bacteria on the antibiotic itself. This is an additional advantage in the treatment, since the probability of resistance of microorganisms and failure of treatment decreases. The cost of such drugs is somewhat more expensive than simple aminopenicillins.
Amoxicillin clavulanate( amoxicillin + clavulanic acid).Tablets 375 mg, 625 mg, 1 g
Available under the trade names: amoksiklav, panklava, flemoklav solutab, augmentin.
3. "Respiratory" fluoroquinolones.
Levofloxacin( Levolety, gloe, tavanic, eleflox, floracid), tab.500 mg
Moxifloxacin( Avelox), tab.400mg
4. Macrolides.
Clarithromycin( Klabaks OD, Clarbac, Clacid, Frromilide), tab.250, 500 mg
Azithromycin( azithrox, zitrolide, sumamed, sumatrolide solutab, chemomycin), tab.250, 500 mg
Antibacterial drugs should never be taken alone without prescribing a doctor. Even with the doctor's recommended admission, it is possible to develop side effects: nausea, diarrhea, fungal infection, allergic rash, etc.
The choice of a specific antibacterial drug for sinusitis is based on the sensitivity of the most frequent pathogens of acute sinusitis( pneumococcus, hemophilus rod, moraxella), the severity of the condition, the presence or absence in the past of allergic reactions to a particular antibiotic, the incidence of side effects, and the contraindications. The drug of the first row is amoxicillin / amoxicillin clavulanate and only in case of its intolerance prescribe antibiotics of other groups( alternative drugs).
Topical( local) glucocorticoids
Can be used in the treatment of both viral and bacterial sinusitis, alone or in combination with tableted antibiotics. The pronounced anti-edematous and anti-inflammatory effect is especially important in patients with concomitant allergic rhinitis. Has no systemic effect( on other organs).
Nasonex( mometasone furoate) nasal spray.1 dose - 50 mcg
Adults with 2 doses in each nasal passage 2 times a day. In connection with the possible risk of side effects( nasal bleeding, the development of secondary infection, pharyngitis, candidiasis, etc.) should only be used as prescribed by the doctor.
Vasodilators for ingestion
Various dosage forms containing ephedrine, pseudoephedrine, phenylephrine, phenylpropanolamine. Reduces swelling of the nasal concha, contribute to the ventilation of the nasal sinuses. Assigned a short course( from 3 to 5 days) with the concomitant violation of the function of the Eustachian tube. Should not be used without prescribing a doctor, especially patients with cardiovascular diseases, arterial hypertension, prostatic adenoma due to systemic vasoconstrictive action.
Antihistamines are NOT recommended for the treatment of acute sinusitis.
Mucolytic agents( thinning viscous nasal secret)
Rinoflumacil. Adults - 2 doses with an interval of 5 minutes in each nasal passage 3-4 times a day.
For children - 1 dose 3-4 times a day.
Course - 5-7 days.
Local means of combined composition
Polidexa with phenylephrine.
Adults - 3-5 injections per nasal passage per day, children from 2.5 to 15 years - 3 injections per each nasal passage.
Duration of treatment - 5-7 days.
Contraindicated in closed-angle glaucoma, allergic reactions to drug components, viral infections, renal failure and kidney diseases with the presence of protein in the urine, children under 2.5 years of age, during pregnancy and lactation.
It is used after consultation with a doctor.
Herbal preparations
OTC drugs, in the absence of individual intolerance, can be used in addition to basic treatment.
Sinupret( dragees, drops for oral administration).Anti-inflammatory drug based on medicinal plants.
For adults - 50 drops or 2 tablets 3 times a day.
Children from 2 to 6 years - 15 drops 3 times a day, at school age - 25 drops or 1 dragee 3 times a day. Course - 7-10 days.
Treatment of sinusitis in children
In children, along with the maxillary sinuses, other sinuses of the nose( polysynusitis) are often involved in the inflammatory process. Treatment is carried out by the same groups of drugs as in adults, adjusted for the age or weight of the child( children's forms of drugs).Nurofen children, Panadol children are prescribed in case of headache.
Treatment of sinusitis in pregnant women
Sinusitis in pregnant women should be treated to prevent the risk of intrauterine infection of the fetus. In the case of viral sinusitis, symptomatic therapy is usually sufficient. Sinupret( dragees), saline solutions are safe. Of the group of antipyretic and analgesic drugs, you can take paracetamol. Vasotherapy drugs of local action are used in pregnant women only if absolutely necessary and according to the doctor's prescription. If the doctor deems it necessary to prescribe an antibiotic, then preference is given to amoxicillin because of its lack of harmful effects on the fetus.
Illiterate and untimely treatment of sinusitis leads to the development of complications, in particular, to chronic sinusitis, when the symptoms persist for more than 3 months. In severe cases, the inflammatory process can move to nearby organs and tissues - the periosteum, periglacial region, the brain. In children, due to the peculiarities of the anatomical structure, complications are more common. As a rule, when a suspected acute sinusitis is suspected, the doctor prescribes a roentgenologic examination of the paranasal sinuses, depending on the results of which he prescribes the treatment and the place of it - at home or in the hospital.
Physician Therapist SE