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Do I Need Antibiotics for a Sinus Infection?


Updated December 04, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Do I Need Antibiotics for a Sinus Infection?

Sinus infections are a big pain, as anyone who’s ever had one can attest. A throbbing sinus headache can make you feel like your head is filled with cement. They’re common, too: Almost 1 in 7 people get a sinus infection each year, and they may be more likely to happen as you age, according to the American Academy of Otolaryngology. So, are antibiotics the cure?


Probably not.

In 2012, new guidelines were issued for physicians treating sinus infections, authored by an 11-member panel that included experts from the US Centers for Disease Control and Prevention (CDC) and the American College of Physicians. Published by the Infectious Diseases Society of America (IDSA) in the journal Clinical Infectious Diseases, the recommendations warn against using antibiotics to treat the problem. The reason? The position paper says as many as 98% of these infections are viral -- that is, caused by viruses rather than bacteria, and therefore will not be cured or even helped with the use of antibiotic medications.

The IDSA guidelines also discourage the use of decongestants and antihistamines, saying they may make symptoms worse. In addition, they recommend non-drug practices like nasal irrigation with saline solution. In the rare event that stagnant or persistent congestion in the nasal passages becomes infected with bacteria, the panel suggests using antibiotics for a shorter period of time, such as 5-7 days, rather than the typical 10-day treatment course.

Many health agencies, including the World Health Organization, have warned of the dangers of over-prescribing antibiotics, which can lead to the development of resistant bacteria, or superbugs.


Anthony W. Chow et al. "IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults."Clin Infect Dis. (2012) doi: 10.1093/cid/cir1043.



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