Why didn’t I get an antibiotic?
You know all the signs. You’re congested, have nasal drainage and a lot of pressure in your sinuses. You’re absolutely sure it’s a sinus infection. When you head in for treatment, though, you receive instructions for self-care instead of an antibiotic.
What gives?
Why didn’t the doctor prescribe an antibiotic?
Katie Schill, nurse practitioner, says this is a common question providers hear, usually followed by, “I received an antibiotic for the same symptoms before.” Schill explained why.
“Medicine is an ever-changing field, and we are always looking at evidence to guide the best practice for our patients. Sinus infections and bronchitis are two illnesses that in the not-so-distant past you used to get an antibiotic for right away; however, evidence is changing,” Schill said.
The latest research shows that 90% of sinus infections are caused by viruses and do not need to be treated by antibiotics.
“We now have evidence to use a more conservative course, which can include decongestants, cough suppressants, inhalers or nasal sprays for a couple of weeks,” she said.
Antibiotics may still be given, but generally only:
- After certain time periods
- If the patient has certain other medical conditions
- If clinical appearance warrants
“We do not support antibiotics for sinus infections before two weeks of symptoms but will start to consider them at 10–14 days for some patients,” she said.
Why not just give an antibiotic anyway?
“It seems like it would not be a big deal to just give antibiotics, especially if patients believe they have an infection. However, giving antibiotics when there is not a clear need is a big part of the reason why we are dealing with so much antibiotic resistance now,” she said. “It may not seem like a big deal for each individual illness, but in a few years when a super infection comes along that is resistant to multiple antibiotics, including the one that was just given without cause, it will become a really big deal.”
Antibiotics also can make you feel worse as they can cause or worsen nausea, diarrhea and stomach pain.
Stick to the age-old home remedies of plenty of fluids and lots of rest and self-care as you heal.
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