Sinusitis and the Necessity of Antibiotics: A Patient's Perspective

Q: Sinusitis and the Necessity of Antibiotics: A Patient's Perspective

Hello： Generally, if a physician diagnoses sinusitis, they will prescribe antibiotic treatment, typically recommended for more than 7 days. <br>If symptoms improve, observation may be considered; however, if yellow nasal discharge persists, a follow-up visit is necessary to conti

Sinusitis and the Necessity of Antibiotic Use

The individual started experiencing a cold and sore throat on Wednesday of last week (the 21st), followed by a runny nose that worsened over the next two days (the 22nd and 23rd), during which they felt alternating chills and warmth.
There was no fever (the individual had previously visited a doctor on Monday due to mouth ulcers).
On the 24th, the sore throat suddenly resolved, but the nasal discharge became thicker, appearing white and green intermittently, with increasing nasal congestion and decreasing discharge.
The individual felt they were recovering and did not believe they needed to see the original doctor, but wanted to confirm some itching in the ears and to clear the congested nose.
After suctioning, the doctor prescribed amoxicillin, which left the individual confused, as they had only prescribed a four-day supply.
This doctor, who has known the individual since childhood, rarely prescribes antibiotics, even in more severe cases of coughing in the past.
The individual is questioning whether the doctor miscalculated the timeline, as they have read several articles stating that bacterial sinusitis is only diagnosed after a certain duration of symptoms.
They noted that their entire illness has not yet lasted a week and are wondering if four days of antibiotics would suffice for sinusitis.
Additionally, they recall experiencing a sensation of body warmth (without fever) when previously taking amoxicillin from a certain manufacturer and are inquiring if this could be an allergic reaction.

Niming, 20~29 year old female. Ask Date: 2016/12/26

Dr. Zheng Jueyi reply Otolaryngology

Hello: Generally, if a physician diagnoses sinusitis, they will prescribe antibiotic treatment, typically recommended for more than 7 days.
If symptoms improve, observation may be considered; however, if yellow nasal discharge persists, a follow-up visit is necessary to continue antibiotic use.
A sensation of body heat is generally not a typical manifestation of drug allergy.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/12/26

More Info

Understanding sinusitis and the necessity of antibiotics can be quite complex, especially from a patient's perspective. Sinusitis, or inflammation of the sinuses, can be caused by various factors, including viral infections, bacterial infections, and even allergies. The symptoms often include nasal congestion, thick nasal discharge (which can be yellow or green), facial pain or pressure, and sometimes fever.
In your case, it seems you experienced a progression from a common cold to symptoms suggestive of sinusitis. The timeline you provided indicates that you started with a sore throat and nasal discharge, which then worsened to a thicker, colored discharge. This progression is typical in viral upper respiratory infections, which can sometimes lead to secondary bacterial infections, particularly if symptoms persist beyond 10 days or worsen after an initial improvement.

Your physician's decision to prescribe amoxicillin, an antibiotic, may have been based on the concern that your symptoms indicated a bacterial infection, despite the fact that you felt you were improving. Generally, antibiotics are recommended for sinusitis when symptoms are severe, persistent (lasting more than 10 days), or if there is a sudden worsening of symptoms after an initial improvement. However, in cases where symptoms are mild and improving, the use of antibiotics may not be necessary.
The four-day course of amoxicillin you received is somewhat atypical for treating sinusitis, as standard treatment usually lasts 10 to 14 days. This shorter duration might suggest that your physician was cautious, perhaps anticipating that your condition could resolve without extensive antibiotic treatment. It's also possible that your physician was trying to avoid unnecessary antibiotic use, which is a growing concern in medicine due to antibiotic resistance.

Regarding your experience with feeling warm after taking amoxicillin, this could be a side effect of the medication, but it is not necessarily an allergic reaction. Allergic reactions typically present with symptoms such as rash, itching, swelling, or difficulty breathing. If you only felt warm without these symptoms, it may just be a response to the medication or your body fighting off the infection. However, if you experience any concerning symptoms, it is essential to contact your healthcare provider.

In summary, while antibiotics can be necessary for treating bacterial sinusitis, their use should be carefully considered based on the duration and severity of symptoms. If you feel that your symptoms are improving, it may be worth discussing with your physician whether the antibiotic treatment is still warranted or if you can continue to manage your symptoms with supportive care, such as hydration, nasal saline rinses, and over-the-counter medications. Always feel empowered to ask your healthcare provider about the rationale behind their treatment decisions, as understanding your treatment plan is crucial for your health and peace of mind.

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