The causative agent of sinusitis and its treatment

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Medicamentous treatment of sinusitis: what drugs are used for genyantritis

Genyantritis is one of the most common diseases faced by millions of people around the world.

Sinusitis is an inflammation of the maxillary sinus (maxillary sinus).

Due to certain features of the structure of this sinus, the mucus that forms as a result of the disease can not be excreted out of the sinus naturally and stagnates.

Medical treatment of sinusitis is selected depending on the cause that caused the disease, as well as the stages of development and the form that the disease took in each specific situation. If the treatment scheme for this disease is not chosen correctly, then in the future it can lead to the most various unpleasant consequences, including, for example, loss of vision, meningitis or sepsis.

Antibiotics for sinusitis

Flemoxin Amoxicillin Sumamed Azithromycin Zinnat for children

There are three types of pathogens that can cause this disease:

  • Bacteria. Staphylococcus aureus, pneumococcus, anaerobes, streptococci, as well as hemophilic infection and Moraxella catarrhalis can be the causative agents of maxillary sinusitis.
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  • Viruses. Causes ARVI and ARD, in which the amount of mucus in the sinuses of the nose increases significantly, which leads to inflammation, to which the bacterial component can also join.
  • Fungi. They become agents of the disease in people with weakened immunity, as well as diabetes, leukemia or AIDS.

It is important to know

It is only the qualified otolaryngologist who can make a correct determination as to which version the disease belongs to, after conducting an examination and giving directions for some analyzes. He also prescribes the necessary treatment of sinusitis with the most effective medicines.

The choice of drugs for sinusitis and the program of procedures completely depend on which causative agent caused the disease and on the severity of the patient's condition. In any case, treatment should be directed both at direct destruction of the infection and at then, to minimize pain and reduce swelling of the sinuses by removing the accumulated mucus.

So, what kind of drugs can be used for the treatment of medicinal treatment of sinusitis?

Antibiotics. One of the main causes of sinusitis is pathogenic microorganisms. In this case, the treatment of maxillary sinusitis with antibiotics becomes effective.

However, it is worth noting that in this case too short or, on the contrary, an excessively long course of treatment can only do much harm. In particular, if the course of taking antibiotics lasted only 3-4 days, then there is a fairly high probability that you will get sick again.

In the event that the treatment period lasts for more than two weeks, the bacteria can become immune to the antibiotic. In this situation, the doctor can prescribe the course of an antibiotic, then recommend switching to another, so that the causative agent of the disease is not used to the active substances used for treatment preparations. Nevertheless, taking antibiotics often gives visible results within 48 hours after taking a headache and it becomes much easier to breathe.

Essential preparations

Sinupret Bioparox Derinat Miramistin SinuforteMalavite

Vasoconstrictive drugs. Used for topical application and serve to reduce the swelling of the nasal mucosa and restore the drainage of the nasal sinuses. Such drugs are most often sprays, ointments and nasal drops. Vasoconstrictors should be instilled in the nose or laid in the nasal passage with a small moistened tampons. It is most advisable to use vasoconstrictive drops in combination with the administration of ointments of a longer duration.

For example, one of the popular vasoconstrictors for the treatment of common cold in adults and children: Nazivin and Nazivin child.

Antibacterial drugs. Amoxicillin, erythromycin and azithromycin will help you to fight infection successfully. It is worth noting that the treatment with drugs such as amoxicillin, with genyantritis in its chronic form is possible only in periods of exacerbation, in this case it is preliminary to determine by means of analyzes the degree of sensitivity of microorganisms to antibiotics.

Hyposensitizing drugs. Such drugs are the best remedy for sinusitis caused by various allergic reactions. Among the most suitable antihistamines for this purpose are terfenadine, loratadine and others.

Nasal drops

Isofra Rinoflumucil Dioxydin Xylen Polydexa Children's Nazivin Sanorin Children's OtryvinNazonexPinosol

Mucolytic agents. Excellent liquefy mucosal discharge and help to withdraw them from the sinus cavity. To this end, most often used guaifenesin, which effectively works even in small doses.

Corticosteroids. Powerful anti-inflammatory drugs that can significantly reduce mucosal edema and improve the drainage of nasal sinuses. Nevertheless, it is worth remembering that hormonal drugs are absolutely contraindicated in using pregnancy, old age, severe forms of diabetes, mental illness, as well as ulcerous diseases of the digestive tract.

It is strictly forbidden to use Isophora during pregnancy or breastfeeding, since all drugs of the aminoglycoside series are toxic to the fetus, which can lead to serious health effects child.

Corticosteroids with medical treatment of sinusitis are used mainly in combination with antibiotics.

It is important to know

In order to prevent unwanted complications and side effects in the treatment of corticosteroids should adhere to a diet rich in proteins and vitamins, as well as limit the intake into the body chlorides. If necessary, the doctor can additionally prescribe potassium preparations.

Homeopathic Remedies. Due to raw materials of natural origin, from which the preparations of this group are made, homeopathic remedies do not cause side effects and addictions. Activates the body's defenses. Correctly selected by a homoeopathic doctor, a remedy for sinusitis can begin to have a beneficial effect on the body within the next 15 minutes.

Quite often, in combination with drug treatment of sinusitis, a variety of Physiotherapeutic procedures, including warming up, as well as laser therapy and other methods treatment. Also can appoint antiviral immunomodulating agent Sinupret. It is available in the form of drops, syrup, blue syrup (tablets).

It is worth remembering that at the first signs of maxillary sinusitis you should immediately consult a doctor, because only timely treatment will get rid of this disease.

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What drugs are used to treat sinusitis, the most effective remedy for sinusitis

Since the time of zemstvo medicine, when there was one doctor in the whole district, whose specialization was surgery, the treatment of maxillary sinusitis was reduced to the principle "where there is pus, wider open".

The wall of the maxillary sinus under local anesthesia was pierced with a wide needle or trocar, after which it was drained with pumping out purulent contents.

This practice existed in the eighties of the last century, leading to the successful disposal of acute sinusitis, but increasing the risks of recurrences that led to subsequent punctures and the formation of a chronic fistulous passage between the maxillary sinus and the cavity nose.

With the appearance in the pharmacological assortment of a large number of various antiseptics and antibacterial means, the treatment of sinusitis has passed to a new qualitative level and is now being carried out in most cases conservatively.

To the credit of modern otolaryngology, it should be noted that the rejection of the surgical route led to a very decent results, both with direct treatment of the disease, and in terms of results. Much less chronic process became, much less stress experienced by the patient, relieved of the need for painful and scary surgical manipulation of the puncture.

What are the real possibilities of medicinal treatment of sinusitis today, and how to choose the least cheap and effective drug set (to treat sinusitis with one drug is still not yet have learned)?

What are the medicines used for sinusitis?

Since the basis of the inflammatory (catarrhal or purulent) process in the maxillary paranasal sinus is infection (more often microbial, less viral or fungal), then by treating the antritis, the drugs choose antimicrobial, antiviral or antifungal.

Antibiotics

Antibiotics - a favorite brainchild of medicine of the 20th century, however, is not the best cure for sinusitis. If treatment is carried out in a clinic equipped with a decent baklaboratoriya and before the beginning of treatment Separated sinuses are sown for the purpose of determining the pathogen and its sensitivity to the antibiotic - it's up to the small.

It remains to choose the drug that shows the greatest activity against the microbe. In this case, one has to take into account that the result of the analysis (sensitivity in vitro) may not coincide with the real working conditions of the antibiotic in the body.

Therefore, immediately choose the strongest drug (in the absence of contraindications and, in the first place, allergic reactions to it). Most often, antibiotics are prescribed empirically, that is, experimentally, based on indications (the presence of yellow or green discharge from the nose, the body's temperature reaction). In this case, a wide-spectrum drug is selected that is active against the majority of potential activators of sinusitis.

Penicillins

For today, they have already lost in the struggle to the majority of microorganisms. And especially staphylococci, which are on the third place among the causative agents of acute or chronic sinusitis (after streptococci and hemophilic rod). However, often in the absence of crops, therapy begins with inhibitor-protected penicillins, which contain additional additives that prevent bacteria from destroying the drug. In addition, penicillins are still an effective tool in the fight against streptococci, which is capable of cause severe complications from the kidneys and joints, as well as secondary rheumatic valve heart diseases.

The most popular tablets are Clavulonate Amoxicillin under the trade names Panklave, Amoxiclav, Flemoclav and Powder for Suspension Augmentin. Sulbactam Ampicillin with names Ampixid in tablets and injections, Unazine, Sultamycillin in injections.

Amoxiclav is a combination of amoxicillin and clavulanic acid, active against golden staphylococci, pyogenic and pneumonia streptococci, Escherichia coli, enterobacteria, moraxella and Klebsiella. Thus, it covers most of the spectrum of potential activators of sinusitis. In tablets, the drug is taken in children at the rate of 40 mg per kg of body weight in three divided doses per day. For people over 12 years, 1 tablet (125 mg + 250 mg) every 8 hours or tablet (125 + 500 mg) every 12 hours. The course of therapy is 7 days.


Cephalosporins

The cephalosporins of the second (Cefaclor) and the third (Ceftibuten, Cefixim) generations, because of widespread use, have now made room for and have given way to macrolides. However, in the conditions of budget deficit and growing prices for medicines, they still have not left the stage.

Cefixime (Suprax, Panzef, Tsemideksor) - pills that suppress the growth of hemophilic rods, streptococci, moraxelli, Klebsiella). In half it is excreted by the liver and kidneys. 400 mg of the drug are taken once a day or in half the dosage twice (in adults and children over 12 years). Among the side effects: skin allergy, dry mouth, nausea, diarrhea, abdominal pain, pseudomembranous colitis, growth hepatic transaminases, dizziness, headaches, drop of white blood cells and blood platelets, rarely - interstitial nephritis. The drug is contraindicated for allergies to penicillins and cephalosporins.

Macrolides

Macrolides (Azithromycin, Jozamycin, Clarithromycin) are used in tablets and suspensions in children and adults in courses of 3-5 days. They show similar activity to inhibitor-protected phellenines with less resistance of microorganisms.

Azithromycin (Azitralum, Sumamed, Hemomycin) tablets of 500 or 250 mg are used at a dosage of 500 mg once daily. Side effects are similar to those of cephalosporins. Drugs are undesirable for allergies to macrolides, are questionable when used in pregnant and lactating women.

Fluoroquilones

These are drugs exclusively of adult practice, since they still refer to reserve funds and should used in extreme cases, so that the cross-insensitivity to bacteria does not develop. They have the property of killing bacteria by blocking their DNA. Lomefloxacin (Lomeflox, Lomacin, Xenacvin), Ciprofloxacin (Infipro, Quintor, Zindolin), Ofloxacin (Glaufos, Zanotsin, Kirol), Norfloxacin (Negaflox, Loxon), Levofloxacin, Moxifloxacin, Sparfloxacin (Sparflot).

Locally antibiotics

Local antibiotics sprinkle in the form of a nasal spray: Framicetin (from the group of aminoglyosides, Isofra). The medicine is used 4-6 times a day for 7-10 days.

Antiseptics

These are the drugs of choice in the treatment of viral sinusitis. Since most viral antritemics are treated with antiviral agents, it is expensive and useless (most of the drugs do not have a solid Evidence base), the main goal in viral sinusitis is to provide a decent outflow from the sinus and try to sanitize the cavity nose:

  • Dioxydin in 1% solution. It is taken from the ampoule into a 10 ml syringe. From which it is buried in the nasal passages, which can also be washed with the drug. The remedy, in fact, is a powerful antiseptic, killing the majority of viruses and bacteria, which is undesirable to swallow "so as not to harm the stomach." In children's practice is not used because of toxicity. For the same reasons, it is not used in pregnant and lactating women.
  • Miramistin is a chlorine-containing antiseptic of the widest spectrum of action. It has no color, smell and practically taste. In adults it is used for washing, and for children for instillation into the nose. May cause local allergy. Not contraindicated in pregnancy and lactation. Read more here.
  • Furacillin in solutions, 2% is used to wash the sinuses. At home, the solution is prepared from two tablets and a glass of water. For washing, use a baby syringe or a 20 gram syringe. The ENT doctor uses an apparatus consisting of a leading tube through which a solution and suction pump is pumped into the nasal passage to pump it out. The course of washes consists of 3-10 procedures, can be complicated by otitis. Furacillin is bitter enough, but it is not dangerous to swallow it in small amounts (which usually happens when rinsing).
  • Prothorgol is a solution of silver, very effective in the bacterial process in the sinuses, especially in children. It is digested 2-3 drops in each nasal passage for 7-10 days. For today, it is rarely used under the pretext of accumulation of silver ions in the body and its chronic poisoning, which according to the fair opinion of the otolaryngologists of the Soviet school is complete nonsense. The tool worked, works and will work, while it is prepared in pharmacies. The agent is suitable for 2 weeks if stored in a refrigerator.

Bacteriophage solutions

Again, the Soviet operating time, forgotten and clogged with the antibiotic lobby of the pharmaceutical industry. With staphylococcal or klebsiellosis maxillary sinusitis in children's practice and resistant microflora - worthy preparations for topical application in the form of rinses or drops in the nose.

Solutions for washing the nose

Dolphin, Aquamaris, Salin, Akvalor is a tricky advertising trick selling saline (,% NaCL, that is, sodium chloride solution) at the price of decent antibiotics. Rinse your nose with sinusitis is not harmful, it is harmful to pay for a solution of table salt fabulous money. So for a bottle of sterile saline solution of 20 ml you will have to pay no more than 40 rubles.

At the same time, a 10 ml bottle of Aquamaris costs more than 110 rubles, Saline for 30 ml - from 137 rubles, and 30 bags of Dolphin, each gram of powder in each cost 190 rubles.

The same audience that patented versions of saline are recommended as less safe (it is not clear, why), that is, children, in general, the lavage of the nose at home is not subject to the high risks of secondary inflammation middle ear.

A couple of words on how to rinse your nose correctly. Before washing, it is necessary to stand over the sink, bending forward at a right angle. After a deep breath, the breath is delayed. The washing container is firmly attached to the nostril. Then it slowly rises so that the solution flows out of the opposite nostril. Washed one, then the other half of the nasal passages and, if possible, sinuses. Remains of the solution are removed from the nasal passages by active blowing out.

GeloMirtol and GeloMirtol Forte

This is an alternative to antibiotics in the fight against sinusitis. This homeopathic drug, oddly enough, works. This effective remedy for sinusitis in combination with dioxin can cure acute uncomplicated sinusitis for a week. It is based on myrtole, supplemented with cineol, limonene, pine, rapeseed oil.

The whole mixture is encapsulated in a gelatin capsule that dissolves in the intestine. The drug has a weak antibacterial, anti-inflammatory effect, and improves the outflow of secretions from the sinuses and nose. Contraindicated with allergies to drug components, bronchial asthma, cholelithiasis, in the first trimester of pregnancy and in children under 6 years.

Nasal drops

Drops can drip during a genyantritis, but it should be not any what, and correct drops:

  • Clean vasoconstrictors with maxillary sinus dripping is not desirable. The duration of their application (with a strong nasal congestion, interfering with sleep) should be limited to five days. Means of this group: Xylometazoline (Otrivin, Galazolin, Ximelin), Nafazolin (Sanorin, Naphthysine), Oxymetazoline (Nazivin, Nazol).
  • Much more preferable mixture of essential oils (Sinupert, Pinosol, Sinuforte) or combined drops: vasoconstrictive phenylephrine in combination with anti-allergic fenistil (Vibrocil) or Rinoflumycil (acetylcysteine, improving efflux and vasoconstrictive thiamine-heptane sulfate).
  • There are also Polydex (vasoconstrictive with antibiotic and corticosteroid), Rinoprint (antihistamine and vasoconstrictor), Dr. Taiss Nasoline (eucalyptus oil and vasoconstrictor xylometazoline).
  • Sinuforte is a cyclamen from a genyantritis in the form of an extract of lyophilizate and juice of tubers. 2-3 drops are sprayed into each nasal passage once a day for two weeks. The drug is prohibited for pregnant and lactating. It can cause local allergy, therefore it is contraindicated to allergic people. Also, it should not be used for polyps in the nose and unregulated hypertension.

Auxiliary drugs

These are antipyretic and anti-inflammatory drugs (Nurofen, Ibuprofen, Paracetamol), as well as antiallergic means 2 and 3 generations, reducing the swelling of the mucous sinuses and nose (Loratadin, Desloratadine, Cetrin, Zinnerit, Claritin, Claricens).

Thus, treatment with antibiotics of sinusitis is not a necessary condition for successful conservative therapy. It is much more important that edema should be eliminated, the outflow of sinus contents adjusted, and the local sanation of the inflammatory focus should be carried out.

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Sinusitis - treatment with antibiotics

Sinusitis- this is one of the types of sinusitis, which causes inflammation of the maxillary sinuses of the nose. Genyantritis is quite a complicated disease from the point of view of treatment, after all, it often appears as a complication of an infectious disease - flu, scarlet fever, measles, etc. The treatment of sinusitis should be treated with due responsibility, as in many cases it recurs and requires a puncture, which is a rather painful procedure.

When the pathogen of inflammation is the bacteria, then in the treatment can not do without antibiotics. Today, many believe that this disease can be cured by folk remedies without resorting to progressive pharmaceutical medicines, and this position generates a lot complications, since for the destruction of microbes effective antibiotics are needed, to which they, by the way, are able to get used, and then large dosages and replacement are required facilities.

Sinusitis - symptoms and treatment with antibiotics

To find out what to treat sinusitis, and what antibiotics are effective, you need to collect detailed information about the pathogen.

So, the cause of sinusitis can be:

  • Staphylococci - as a rule, it is these bacteria that cause inflammation;
  • streptococci;
  • viruses;
  • fungi;
  • haemophilus influenzae;
  • mycoplasma;
  • chlamydia.

In more rare cases, an allergic reaction or curvature of the nasal septum promotes sinusitis.

When antimicrobials are necessary for sinusitis, it is a question of staphylococci and streptococci, as well as chlamydia and mycoplasma. Fungi, hemophilic rod and viruses are resistant to the antibiotic, and, moreover, can develop against the background of antibacterial therapy.

What antibiotic is better to take with genyantritis, should suggest an analysis of the pathogen, because staphylococcus and streptococcus, for example, are sensitive to penicillin, while chlamydia have resistance to penicillin. On the basis of experiments it was proved that he is able to stop their development only in the case of taking large doses, which is not always justified in treatment. The only exception here is the type of penicillin - amoxicillin, which can be taken up to 1500 mg per day for 7 days so that the effect of treatment is achieved.

What antibiotics should I take with genyantritis?

So, depending on the causative agent of the disease, it is advisable to treat sinusitis with antibiotics, to which the bacterium is sensitive.

What antibiotics to drink at a genyantritis, if the causative agent of staphylococcus or streptococcus?

To treat sinusitis in this case, suitable antibiotics penicillin series:

  • ampicillin;
  • bicillin-3, bicillin-5;
  • benzylpenicillin.

In the case of an allergic reaction to penicillin, antibiotics of another series are prescribed:

  • erythromycin;
  • oleandomycin.

Effective antibiotics in tablets with maxillary sinusitis caused by chlamydia

If the causative agent of sinusitis are chlamydia, then the following antibacterial agents are prescribed:

  • rifampicin;
  • amoxicillin - at a dosage of 1500 mg per day;
  • Sorangycin;
  • ciprofloxacin;
  • levofloxacin;
  • norfloxacin.

The last three antibiotics belong to the modern group of fluoroquinolones, and represent one of the safest forms of them.

What antibiotics should I take with maxillary sinusitis caused by mycoplasma?

For the treatment of maxillary sinusitis with mycoplasma pathogen, the following antibiotics are indicated:

  • doxycillin;
  • tetracycline.

Drops with genyantritis with antibiotic

For local treatment in complex antibacterial therapy the following drops are used. With antibiotic content:

  • Isophra - contains Framicetin (group of aminoglycosides);
  • Bioparox - contains fusafungin, is presented in the form of a spray; refers to a group of polypeptide antibiotics that are effective against gram-positive and gram-negative bacteria, as well as fungi.

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Antibiotics for sinusitis - which are the most effective?

Sinusitis - inflammation of the mucous membrane of the accessory maxillary sinuses of the nose. The emergence of this common disease is associated with human-borne viral, infectious diseases, such as influenza, measles (see. symptoms of measles in adults), scarlet fever, as a complication after angina, otitis and other diseases of the ENT organs, as well as in diseases of the roots of the upper molars.

In recent times, cases of allergic sinusitis have begun to increase, as well as after oncological diseases after treatment, with helminthiases (see Fig. signs of worms in humans) and other chronic diseases that reduce the defenses of the body. Treatment of maxillary sinusitis with antibiotics should be only on indications, in complex treatment and is prescribed only by a doctor.

In most cases, self-treatment is not safe, can worsen the condition and slow the recovery process. First of all, you should undergo a checkup with a doctor who will establish an accurate diagnosis, the cause of the disease and prescribe a comprehensive treatment.

Signs of genyantritis

If, after some improvement after the flu or cold, a re-rise in body temperature occurred, the overall condition, there were shooting pains with the tilt of the head down, with a slight tapping in the area of ​​the maxillary sinuses, you can suspect the onset sinusitis. The following symptoms of maxillary sinusitis serve as a cause for referral to a doctor:

  • Stuffy noseconstantly or periodically, the sense of smell is reduced.
  • Discharge from the nosecan be both abundant, purulent, yellow-green in color, and transparent, in rare cases they may be absent, this occurs if the sinuses are already filled with pus and the discharge is very thick.
  • Sense of pressure, raspiraniya, stress in the sinuses of the nose.
  • HeadacheIncreased when the body tilts forward, upside down.
  • Severe painin the forehead, in the maxillary sinuses, cheekbones, cheeks, localizing only in one half of the face, or in a bilateral process - on the entire face. In acute process, pain can be pronounced, and in chronic sinusitis, not so intense, sometimes a person simply experiences pain in the eye area or headaches.
  • Temperature,in acute maxillary sinusitis, it can be quite high, above 38C, with chronic often subfebrile or normal.
  • The general state of weakness,increased fatigue. Due to congestion of the nose, headaches, the person is disturbed by a sound sleep, appetite decreases, a feeling of apathy, lethargy, depression develops.

Diagnosis of genyantritis

Anamnesis of the patient.Before the diagnosis is established, the doctor analyzes the patient's anamnesis, finds out the diseases that preceded the genyantritis (influenza, SARS, otitis, tonsillitis, inflammation of the teeth of the upper jaw), a tendency to allergic manifestations (pollinosis, urticaria, bronchial asthma, etc.), food intolerance, medicines. The factors that provoke the development of sinusitis include:

  • Decreased immunity due to any chronic diseases, allergic reactions, helminthiases, metabolic disorders.
  • Curvature of the nasal septum obstructing normal nasal breathing, congenital anomalies of anatomical structures in the nasal cavity.
  • Vasomotor, hypertrophic, allergic rhinitis, adenoids in children.
  • Inadequate treatment of influenza, colds, SARS, rhinitis.
  • Diseases and removal of teeth of the upper jaw.

X-ray diagnostics. To date, the most reliable method of diagnosis of maxillary sinusitis is still X-ray, and with modern contrast tomography, the accuracy of diagnosis has increased at times. A snapshot can give information about the size, the volume of the sinuses, their fullness with pus, air. Sometimes the doctor recommends an X-ray in several projections - lateral, nasal-chin or frontal-nasal. With genyantritis, the images show different types of darkening, this is explained by the delay in the rays of the medium, which is denser than air. However, one should remember about the dangers of X-rays and CT (the risk of thyroid cancer increases, etc.), fluorography of the paranasal sinuses is sufficient, and the radiation load is minimal.

Puncture of maxillary sinuses- this is an informative method of diagnosis, but an outdated method of treating sinusitis. In view of possible complications (emphysema of the cheek, abscess of the orbit, embolism of the blood vessels), morbidity of the procedure and the transition of sinusitis to a chronic inflammatory process, it is carried out Rarely enough.

In connection with the application of the newest technologies for the treatment of sinusitis - the use of the sinus catheter "Yamik laser therapy, the plant medicine Sinuforte (increasing local immunity and excellent cleansing of the sinus), the frequency of using the nose puncture method for sinusitis for its treatment and diagnostics.

Bacteriological culture of a smear from the nose- as an independent diagnostic method for determining sinusitis or not - it does not matter. Carrying out of this diagnosis is expedient only for the choice of an antibiotic for sinusitis, to which the pathogenic microorganisms were sensitive.

When is antimicrobial therapy not recommended?

To begin with, you should determine the true cause of the genyantritis, its pathogen. Since with some provoking factors that cause sinusitis, antibiotic therapy can not only ineffective, but also capable of exacerbating inflammation, delaying the process recovery.

  • If sinusitis occurs as a consequence of allergic manifestations, then in this case, the intake of antibiotics is not justified.
  • With chronic rhinosinusitis, antritis associated with fungal infection, also taking broad-spectrum antibiotics only aggravates the process.
  • In viral infections, when mild sinusitis can be helped by lavage, inhalation and immunotherapy, it is also not worth taking antibiotics.

When you can not do without antibiotics?

But with an acute bright process, with a high temperature, expressed by a general intoxication of an organism not of a viral origin, strong pains in the sinuses of the nose, purulent discharge from the nose - intake of oral antimicrobial agents or intramuscular injection of an antibiotic are needed.

Which antibiotics are most effective?

The best antibiotic for sinusitis is the one to which the inflammation agent is sensitive according to the smear analysis. If within 72 hours after taking the antibiotic, there is no apparent relief, then either the drug of the pathogen was stable, or the cause of maxillary sinusitis is not bacterial, but fungal or allergic.

If the genyantritis is caused by banal streptococcus, staphylococcus, hemophilia, then the following groups of antibiotics are used:

  • Penicillins- Most preferred, because they have less side effects, are easily tolerated, but in cases severe inflammatory process caused by penicillin-resistant infections may ineffective. Amoxicillin - (Amosin, Flemoxin solutab), Ampicillin, amoxicillin with clavulanic acid (trade names: Augmentin, Amoxiclav, Flemoklave solutab, Ecoclav, etc.) are distinguished among them.
  • Macrolides- their use is justified with intolerance of penicillin drugs. Trade names of the drugs are Zitrolide, Sumamed, Macropen, Clarithromycin.
  • Cephalosporins- this group of antibiotics is prescribed in cases of severe inflammation and with the inefficiency of other antimicrobial agents. These include - Ceftriaxone, Cefotaxime, Cefuroxime, etc.
  • Fluoroquinolones- most bacteria have not yet managed to form resistance to these synthetic drugs, so they are also used to treat sinusitis (contraindicated to children). Antibiotics of this series - Ofloxacin, Lomefloxacin, Ciprofloxacin (1 generation), Levofloxacin (2 generations), Moxifloxacin (3 generations).
  • Local treatment- drops in the nose with an antibiotic. The use of local local antimicrobial sprays, drops at the onset of the disease can help avoid oral or intramuscular systemic use of broad-spectrum antibacterials with their inherent adverse effects on the whole organism. Such drops include Isofra, Polidex.

When choosing an antibiotic should be guided by the individual characteristics of the patient, concomitant diseases, possible allergic reactions to it. And most importantly, the selection is best done taking into account the data of the smear microscopy and rapid assessment of the pathogen for staining by Gram stain, otherwise the treatment of sinusitis with antibacterial agents may not be effective, with wasted time and means.

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Causes, symptoms and treatment of sinusitis

With a disease of sinusitis, ENT doctors face very often. Therefore, everyone should know about sinusitis, treatment, symptoms. How can we recognize this ailment? Of course, you should seek help from a doctor, until complications arise. And the genyantritis itself has quite unpleasant manifestations. But still, let's look at the causes, symptoms and treatment of the disease so that it does not catch you unawares.

What is sinusitis?

Sinusitis is the most common disease in the practice of an otolaryngologist, which causes inflammation in the maxillary, or, as it is called anatomically, a maxillary sinus. In adults, the maxillary sinuses are the largest. They have a connection with the nasal passage in its upper third, this connection is small in size. Due to this structure, the contents of the sinus can stagnate, an inflammatory process occurs.

The disease, which inflames not only the maxillary sinus, but also others, is called polysynusitis. Sinusitis can affect only one or both sinuses. They are symmetrical and are located to the right and left of the nose.

Isolate acute and chronic sinusitis. Acute lasts less than 3 weeks, is amenable to therapy. It can re-occur under the influence of adverse factors. Chronic sinusitis lasts more than 3 weeks, has periods of exacerbation and remission. It occurs in the presence of adverse factors, such as a violation of the structure of the nasal septum, polyposis of the nasal mucosa, dental diseases (upper 8, 7 teeth).

Causes of sinusitis

Most often this disease develops against the background of acute respiratory infections, influenza, colds, hypothermia, trauma, bacterial infection. Not every ARVI leads to the development of sinusitis. It should also be noted genetic predisposition. Subcooling can develop if there is no headgear in the cold season.

The causative agents of the disease are streptococci or staphylococci, much less often pneumococci, fungi, mycoplasma. To develop the disease is not enough penetration of microorganisms in the sinuses, their volume should exceed the reactive capacity of the body. That is why the inflammation of the maxillary sinuses develops at the moment of stress for the organism, for example, when a virus infection occurs.

There are forms of sinusitis, in which the discharge does not contain the pathogenetic flora. These are allergic sinusitis, vasomotor, serous. In chronic sinusitis pathogens are several microorganisms at the same time.

Allocate purulent and catarrhal sinusitis. When the catarrhal form is inflammation of the mucous membrane, it becomes thickened, bulky, can occupy the entire sinus. When purulent form on the mucous surface there is abundant pus, or purulent-hemorrhagic discharge. With this form, the inflammatory process can penetrate into deeper layers.

Symptoms of genyantema

Most often, patients complain of pain in the area of ​​the sinuses.It can be spilled, with pressure on the sinuses intensify and irradiate in the temple, on the entire half of the face.Sometimes patients notice an impassable headache. Most often, nasal breathing is difficult on the side of the lesion. Difficulty breathing from both sides. Discharge from the nose at the onset of the disease is serous, then becomes cloudy, purulent. The sense of smell is reduced.

Manifestation of sinusitis is accompanied by an increase in body temperature (up to 3, ⁰С and above). But more often it is subfebrile indicators, the disease can also occur at normal temperature. The working capacity decreases, the patient can not concentrate on his activity. With difficulty breathing, the patient is forced to breathe through the mouth. Some note the heaviness in the head.

To diagnose sinusitis, you need to contact a specialist. He will conduct an examination of the patient, listen to complaints and may prescribe an X-ray study. X-ray picture will show not only the state of the sinuses at the time of treatment, but also features of the anatomical structure of the nasal passages and sinuses. Sometimes this is of tremendous diagnostic importance.

In some severe cases, a diagnostic puncture can be prescribed. Now they try to use it as rarely as possible. In severe sinusitis, as well as in childhood, the patient may be offered hospitalization in a hospital. In the hospital it is most convenient to conduct surgical treatment, if it is shown. Remember: the treatment of sinusitis can be performed only by a doctor.

Treatment of genyantritis

For the treatment of sinusitis, the following means and methods are used:

  • vasoconstrictor drops in the nose;
  • antibacterial therapy;
  • physiotherapy;
  • sinus puncture with the introduction of drugs.

Vasodilating drops are necessary to reduce the volume of the mucous membrane. This helps to remove the accumulated secret. Currently, there are a lot of such drugs.

This is nasivine, naphthyzine, xylometazoline, galazoline, ximelin, rhinorus, snoop, sanorin and a number of other agents. Currently, you can select these funds for any budget.

But it should be remembered that these drugs should not be used for more than 5 days, as they can be addictive and, for prolonged use, affect other systems.

The vessels of the heart and other internal organs may contract. To treat the disease with vasoconstrictive drugs is not recommended for pregnant women, since these drugs can cause constriction of the blood vessels of the placenta, causing hypoxia in the fetus.

Antibacterial drugs can be prescribed only by a doctor. It should be remembered that the unsystematic administration of antibiotics leads to the development of resistance of microorganisms to their effects. Antibiotic therapy should be rational, aimed at the alleged pathogen. Drugs should be used for as many days as the doctor prescribed. Self-administration of drugs such as penicillin, cefazolin, ceftrioxone, can harm your health.

Physiotherapy with genyantritis is aimed at improving the patient's condition. With its application, the outflow of sinus contents improves, the edema of the mucous membrane decreases. Most often, electrophoresis of the maxillary sinuses, magnetotherapy. If these physiotherapy procedures are not enough, inhalation is possible. Warming procedures for sinusitis are not recommended, as increased blood flow in the maxillary sinuses can lead to a more intense swelling of the nasal mucosa.

One of the most frequently performed manipulations in ENT practice in the inpatient department is the puncture of the maxillary sinuses. This manipulation is carried out according to the doctor's prescription. Using a puncture needle, a puncture in the sinus wall is made and the contents are extracted. Then they wash the sinus with a disinfectant. Repeat this procedure several times, it is very unpleasant, but necessary. In children, the maxillary sinuses have a smaller volume, and their puncture is undesirable. Also, children may experience complications when performing a puncture. The likelihood of complications in children is higher than in adults.

New drugs for sinusitis

Currently, there is a large number of local antibacterial drugs. These include polidexa, isofras. These drugs are designed to treat sinusitis and bacterial sinusitis.

Polidexa is a complex drug that has antibacterial, anti-inflammatory, vasoconstrictive effects. It is its complex effect that significantly alleviates the patient's condition. Thanks to this remedy, patients get the opportunity to recover from sinusitis without performing a puncture of the maxillary sinuses. It affects both gamma-positive and gamma-negative microorganisms. It can be used to treat children, but strictly following the instructions.

The composition of the polidex spray:

  1. Neomycin sulfate.
  2. Polymyxin B sulfate.
  3. Dexamethasone sodium metasulfobenzoate.
  4. Phenylephrine hydrochloride.
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The nasal isophra spray is a one-component, contains Framicetin. Its effectiveness is somewhat lower with genyantritis compared with polidex. This spray should be used before the onset of sinusitis, when the sinuses are still in contact with the nasal passage.

Conclusion on the topic

It is necessary to remember that prevention is the best remedy for sinusitis. This timely treatment of ARVI, therapy, even mild forms of sinusitis, a healthy lifestyle and proper nutrition. Sinusitis is much more likely to develop in people with weakened immunity and in people who are not monitoring their health.

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If you are visiting the pool, it is extremely important to dry your hair after swimming. Wet hair and hypothermia can lead not only to sinusitis, but also to more serious infections, even to the development of meningitis.

lor03.ru

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