Sinusitis is an inflammation of the maxillary sinuses, which can have a bacterial, allergic, traumatic, viral nature. It develops, as a rule, against the background of catarrhal diseases, ARVI or influenza, but it can act as a separate pathology.
In the bacterial nature of sinusitis, the use of antimicrobials is shown to the patient. Without their use, the purulent exudate, located in the sinuses, can "break through", affecting the human brain. A consequence of this may be encephalitis or meningitis.
When are antibacterial drugs needed?
Antibiotics are extremely necessary if sinusitis is accompanied by the release of purulent contents of the sinuses from the nasal passages. The group and dosage of the drug may be prescribed exclusively by the otolaryngologist, based on the clinical manifestations of the disease and the degree of its severity.
Before using antibiotics, two diagnostic tests are mandatory:
- Bacterial culture on the nutrient medium, with the help of which the nature of the disease is precisely determined, as well as its causative agent (the type of pathogenic microorganisms that caused the development of purulent sinusitis).
- Antibioticogram. Such a clinical study determines the sensitivity of a particular type of pathogenic microorganism to certain antibacterial drugs. Thanks to his conduct, the doctor can prescribe exactly the medicine that will give the maximum results in the fight against purulent sinusitis.
So, when are antibiotics needed, and what can the evidence be for their use? They are used if the genyantritis is accompanied by the following symptoms:
- pain in the region of the frontal lobes and orbits;
- pressing sensations in the nose and forehead;
- a significant increase in body temperature (with acute purulent maxillary sinusitis, because chronic almost never causes fever, unless it is subfebrile);
- abundant secretion of purulent exudate;
- obstructed nasal breathing, especially at night;
- intense headaches, which are difficult to get rid of even with the help of strong analgesics;
- discomfort, pain and pressure in the nose and forehead when tilted sideways or to the side.
If you do not start therapy in time, the disease can not only go into a chronic form of development, but also hit the brain. The consequences of such complications can be unpredictable.
Antibiotic therapy is prescribed, usually a week after the onset of the pathological process. It is necessary in the event that the washing of the nose and its washing, as well as medical inhalations have not yielded any results. Prescribe an antibacterial drug can only be your doctor - do not self-medicate, because antimicrobial drugs at their uncontrolled application can cause serious side effects, up to Quincke's edema and anaphylactic shock.
What antibiotics will help?
It is impossible to say unambiguously which antimicrobial drugs will be effective in each specific case. Everything depends on the results of the antibioticogram and bacterial culture on the pathogenic microflora. The doctor will be appointed only that antibacterial medication, to which the causative agent of the disease is most sensitive, and did not have time to develop resistance. The risk of adverse reactions is also considered.
Often, for the treatment of purulent maxillary sinusitis, patients are prescribed the following groups of antibiotics:
- Penicillin. It is this group of antibacterial drugs that are used to treat mild sinusitis of mild severity most often. This is due to the low risk of side effects from their use. However, if there is a serious course of the disease, such medications will not be effective.
- Macrolides. Appointed in the case of intolerance of the patient's body antimicrobial drugs penicillin group.
- Fluoroquinolones. The plus of this series of antibacterial drugs is that most pathogens have not yet developed resistance to them. However, due to the fact that in nature such substances are not synthesized, but are manufactured exclusively in the laboratory, and categorically contraindicated to young children.
- Cephalosporins. Such antibiotics are prescribed in extremely difficult situations - if the genyantritis threatens to "break through" and hit the brain, or go into a chronic form of development. They can also be prescribed if other antibacterial agents are ineffective.
Self-medication with the use of antibiotics is dangerous because many patients begin therapy without making sure that there is no allergy to the selected drug. Allergic tests are an obligatory measure, which is always performed by a doctor before the treatment of purulent maxillary sinusitis in a patient.
List of antibiotics for sinusitis
The choice of antibiotics for the treatment of sinusitis depends on several factors:
- individual characteristics of the patient's body;
- the presence of concomitant diseases;
- risk of allergy or complications after the passed course of antibiotic therapy (dysbacteriosis of the intestine, etc.).
The selection of the drug is also carried out taking into account the results of the study of the smear of nasal secretions using the Gram staining method.
As a rule, the treatment of sinusitis begins with relatively light antibiotics of the penicillin series. They have a bactericidal effect, achieved by blocking the synthesis of cellular elements of pathogenic microorganisms, which are the causative agents of sinusitis. This leads to the death of the pathogenic microflora, resulting in recovery.
List of drugs based on the penicillin series:
- Sulbactams Ampicillin: Sulbacin, Sultamycillin, Ammisid, and others.
- Clavulanates of Amoxicillin: Amoxiclav, Augmentin, Flemoclav, and others.
The use should be done under the close supervision of the doctor, especially if the treatment is prescribed for a small child. Although penicillins are considered to be one of the safest antibacterial groups, nevertheless, it will never hurt to be reinsured.
Treatment with macrolides
Macrolides are given special preference, since they occupy the first place among antibacterial drugs for their safety. They rarely cause side effects, which explains their popularity and relevance.
These drugs do not block the cell membranes of pathogenic bacteria, but have a bacteriostatic effect, that is, prevent further propagation of pathogenic microflora. These properties are especially useful in chronic purulent sinusitis.
Macrolide preparations can be:
- 14-membered: Erythromycin, Clarithromycin and others;
- 15-membered: preparation Azithromycin and its analogs (azalides) (Sumamed, Asitrus, Zitrolide, etc.);
- 16-membered: Midekamycin, Spiramycin, Jozamycin.
The use of cephalosporins
Cephalosporins for the treatment of sinusitis have been used for a long time, and quite successfully. In addition, microorganisms rarely develop resistance to this group of antibiotics, which is also considered their orgasmic advantage.
According to the generally accepted coassification, cephalosporins are:
- 1 generation - Cefazolin, ceflexin and their analogues;
- 2 generations - Cefuroxime, Mefoksin, Zinacef, etc .;
- 3 generations - Cefixime, Ceftriaxone, etc .;
- 4 generations - Tsefpyrom, Cefepim, etc .;
- 5 generations - Tseftolozan, Zaftera, etc.
The use of fluoroquinolones
Fluoroquinolones - synthetic substances, which in their structure and properties are very different from other groups of antibacterial drugs. In the treatment of sinusitis, these drugs are used only in extreme cases. During pregnancy and during lactation, they are strictly contraindicated, since they can cause serious damage to the health of the child.
Fluoroquinolones are divided into 4 generations (the figure of the list shows the number of generation of antibiotics of this series):
- Tarivid, Unikipev, Tarivid.
- Ciprofloxacin, Norfloxacin, Cifrinol, and others.
- Levofloxacin, Ecocylol, Normax.
- Moxifloxacin, Avelox, Gemifloxacin, and others.
An antibacterial preparation is prescribed only after collecting the results of a bacteriological smear from the nose and an antimicrobialogram. Already two days after the start of therapy, the first improvement should occur. If this does not happen, the drug is replaced in an emergency order by another.
Systemic antibiotics for sinusitis
Indications for oral or parenteral use of antibacterial drugs in the treatment of purulent sinusitis are:
- development of intoxication syndrome;
- prolonged course of the disease;
- acute catarrhal sinusitis, accompanied by pronounced symptoms;
- rapid progression of the disease, occurring in acute form;
- presence of abundant mucous or purulent discharge with pronounced nasal congestion;
- severe pain in the area of maxillary sinuses, eyes, frontal lobes, cheekbones;
- development of complications of sinusitis, expressed with the help of otitis, periostitis of the upper segment of the jaw, attachment of a secondary infection, etc.
Oral and parenteral administration of antibiotics often causes complications in the form of allergic reactions and intestinal dysbiosis. For this reason, the patient must be prescribed probiotics in parallel.
Injectable preparations
The most optimal variant of antibacterial drugs against sinusitis, released in the form of solutions for intramuscular injections, is considered a cephalosporin group. If we talk about specific drugs, then often for this purpose, drugs Cefazolin and Ceftriaxone are used. Despite the similarity of the principle of impact on the pathogenic microflora, these funds have some differences.
- Ceftriaxone is a dry powder released in ampoules, and is intended for the preparation of a solution for intramuscular or intravenous administration. It is used for severe sinusitis, and has a powerful bactericidal effect. The powder is diluted with water for injection, or a solution of lidocaine (anesthetic drug). This medicine is extremely necessary in the presence of purulent contents of the maxillary sinuses. Progress is noted after 2-3 injections.
- Cefazolin is also released in the form of a powder for the preparation of an injection solution. It is diluted with sodium chloride, or water for injection. It is used for the treatment of acute sinusitis without pronounced complications. A significant drawback of the drug is its ability to cause powerful allergic reactions, so it is used with particular caution to treat young children.
The main difference between Ceftriaxone and Cefazolin is that this drug has a more powerful effect. About the injection is very painful, but Ceftriaxone causes, nevertheless, a more intense pain syndrome, so the powder is diluted with lidocaine.
Local treatment
Systemic administration of antibacterial drugs is often performed in combination with special solutions for the treatment of the nasal cavity. Here is a list of the most effective drugs.
- Polidex. This antibiotic for the treatment of nasal passages is used extremely rarely, since it can cause serious side effects. It includes neomycin and polymyxin B. However, the spray gives good results in the treatment of sinusitis and purulent sinusitis, and also prevents the development of complications of the disease and the attachment of secondary infection.
- Biparox is an antibacterial preparation for topical application in the treatment of sinusitis. It is released in the form of an aerosol with a dispenser for spraying the medicine in the nasal passages. The active substance is fusafungin. This polypeptide antibiotic perfectly copes with various pathogenic microflora: pathogenic bacteria, fungi, mycoplasma, etc. In parallel, it has an anti-inflammatory effect.
- Isofra is another highly effective antibacterial agent for fighting acute manifestations of sinusitis. The active substance is aminoglycoside of framicetin. The spray copes well with the inflammatory processes taking place in the area of the paranasal sinuses.
Another widely used antibiotic from the category of aminoglycosides, intended for topical application, is Taizomed. The composition of the drug includes the active ingredient torbamycin. It is a broad-spectrum drug that has a powerful antimicrobial effect.
Contraindications and side effects
Antibiotics can not be used to treat sinusitis with:
- presence of allergic reactions;
- pregnancy (without the appointment of a doctor) (see first signs of pregnancy);
- renal failure (preparations Flemoxin, Sumamed, Zitrolide);
- liver dysfunction (Amoxiclav).
Other contraindications to the treatment of antritis with antimicrobials are:
- lymphocytic leukemia;
- Infectious mononucleosis;
- children's age till 12 years;
- impaired blood clotting;
- tendency to open bleeding.
If improperly administered or overdosed with antibacterial drugs, side effects may occur in the form of nausea, vomiting, insignificant a rise in body temperature, hyperemia of the skin, itching, hives, headaches, dizziness, stools, problems with sleep. Children can develop conjunctivitis, worsen overall health, migraine. To avoid this, take the medication prescribed by your doctor correctly!
Are there any children's antibiotics?
Not antibiotics are "adults" or "children's", but the dosage of a drug. Treatment of sinusitis in small patients is mainly based on local application of antimicrobial agents. Basically, these are drops or sprays.
There are other "child" forms of antibiotics:
- suspensions for oral administration;
- tablets (12 years and older);
- injections.
To select a specific drug and prescribe its dosage can only ENT, family doctor or pediatrician. Often doctors recommend the treatment of sinusitis in children with the help of preparations Isofra, Summed, Polidex, etc. Previously, Bioparox was used for this purpose, but now it is banned.
It is very important to correctly approach the use of antibiotics prescribed by a doctor against sinusitis. Their appointment should always be accompanied by an additional prescription of antihistamines anti-allergic and anti-edema drugs. It can be Allerdez, L-Cet, children's Loratadin, and others. For babies are used suspensions and syrups, for older children - tablets. After the end of therapy, it is advisable to take antiallergic drugs for several days to fix the effect.
The main mistake of most parents is an attempt to self-treat sinusitis in a child. Folk remedies, of course, quite often give positive results in the fight against pathology, but they can also hurt. Many recipes of alternative medicine only temporarily remove the problem, but completely get rid of it does not help. Therefore, remember: no one can appoint the most effective remedy for sinusitis - only a qualified otolaryngologist!
Conclusion
Sinusitis is a very dangerous and insidious disease that can cause a number of complications. It can develop gradually, or progress rapidly.
From its stage depends on the appropriateness of using antibiotics and the choice of a particular drug. However, this can be judged solely by the attending physician, so do not risk your health, not wanting to stand in line with the otolaryngologist. Be healthy!
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