Sinus Issues and Antibiotic Use for Cough and Phlegm

Inquiry about cold medications?

Hello Doctor, today I noticed that sometimes the phlegm I cough up in the morning is a bit yellow and sometimes has an unpleasant smell.
I was worried about potential issues with my nasopharynx, so I visited an ENT specialist.
The doctor examined me with a small mirror and said there were no issues with my nasopharynx, but he did see some sticky phlegm and suggested that I might have sinusitis, so he changed my medication (I had taken it once before).
However, I didn't finish the medication because I thought I was better.
Today, the doctor emphasized that I must take the medication as prescribed because it contains antibiotics.
I have three questions:
First, isn't nasal congestion a common symptom of sinusitis? I felt congested a few days ago, but today I don't feel that way.
Could this be due to the medication?
Second, I accidentally took an old antibiotic instead of the new one.
I quickly called the clinic to ask, and the doctor there said it was fine.
I was initially thinking of skipping the red pill today, so will taking these antibiotics together cause any overdose or interference? The last one I took was moxiclav, and this time it seems to be moxifloxacin.

Lastly, will taking this medication for just a few days lead to serious problems, or is it okay to take it for about a week? I saw some scary side effects listed, including seizures or mental confusion.
When I asked the doctor, he said not to worry too much since I won't be taking it for long, but I need to take it regularly for the next few days.
This is the medication bag from today, and the last one seems to be the new antibiotic.
Thank you, Doctor, for your help.

Yueyue, 20~29 year old female. Ask Date: 2021/11/10

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
Sinusitis does not always present with nasal congestion; some individuals may experience symptoms such as pain around the nostrils, fever, or purulent nasal discharge.

2.
Amoxiclav and moxifloxacin are two completely different antibiotics.
In clinical practice, they may be used in combination for more severe cases, so there should not be an issue of redundancy.

3.
Both of these are commonly used antibiotics, and the packaging requires that all possible side effects be listed.
However, the actual incidence of side effects in clinical practice is very low.
It is recommended to complete the antibiotic course on schedule if there are no significant discomforts, as this helps prevent future antibiotic resistance issues.
Thank you for your inquiry.

Reply Date: 2021/11/10

More Info

When it comes to sinus issues and the use of antibiotics for cough and phlegm, it is essential to understand the underlying conditions that may necessitate antibiotic treatment, as well as the implications of using these medications.
Sinusitis, which is an inflammation of the sinus cavities, can often lead to symptoms such as nasal congestion, facial pain, and the production of thick, discolored mucus. The presence of yellow or green phlegm can indicate a bacterial infection, especially if accompanied by other symptoms like fever or persistent cough. However, not all cases of sinusitis require antibiotics; many are viral in nature and will resolve on their own without the need for antibiotic intervention.

In your case, the doctor’s observation of thick mucus and the recommendation for antibiotics suggest that there may be a bacterial component to your sinus issue. It’s crucial to follow the prescribed course of antibiotics, as incomplete treatment can lead to antibiotic resistance and a recurrence of the infection. The antibiotics you mentioned, moxiclav (amoxicillin/clavulanate) and moxifloxacin, are both effective against certain bacterial infections, but they belong to different classes and have different mechanisms of action.

Regarding your concerns about taking two different antibiotics, it is generally not advisable to mix antibiotics without medical supervision. While the doctor you consulted indicated that it was not a problem in your case, it is essential to ensure that the dosages do not exceed the recommended limits and that there are no adverse interactions between the two medications. Moxiclav is a broad-spectrum antibiotic effective against a variety of bacteria, while moxifloxacin is a fluoroquinolone antibiotic that is also broad-spectrum but has a different side effect profile. Taking them together could potentially lead to increased side effects or complications, so it’s always best to consult with your healthcare provider before making any changes to your medication regimen.

As for the duration of antibiotic treatment, a typical course can range from 5 to 14 days, depending on the severity of the infection and the specific antibiotic prescribed. Short courses of antibiotics, such as 3 to 5 days, can be effective for some infections, but longer courses may be necessary for more severe cases. The side effects you mentioned, such as seizures or psychiatric effects, are rare but can occur, particularly with fluoroquinolones like moxifloxacin. It’s important to monitor for any unusual symptoms and report them to your doctor immediately.

In summary, sinus issues can often lead to the prescription of antibiotics, particularly if there is a suspicion of bacterial infection. It is vital to complete the full course of antibiotics as prescribed, avoid mixing different antibiotics without guidance, and be aware of potential side effects. If you have any concerns about your treatment or experience any adverse effects, do not hesitate to reach out to your healthcare provider for further advice. Proper management of sinusitis and adherence to prescribed treatments can help ensure a swift recovery and prevent complications.

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