Submitted by Dr. Samantha Ritchie, Vantage Physicians
Colds are incredibly common, and they often involve sinus pain. You know the sensation –you go through a whole box of Kleenex, you feel crummy and have a low grade fever. Your sinuses feel stuffy and if you lean over, you get sinus pain. But is it a true bacterial sinus infection, and would antibiotics help?
It turns out that almost all sinus infections are viral. According to Up To Date, only 0.5-2% of patients with sinus symptoms have bacterial sinus infections. The medical term for this is “bacterial rhinosinusitis.” That means that only 2 out of 100 patients with an upper respiratory infection and sinus symptoms will benefit from antibiotics. Despite this, over 85% of patients who present with sinus symptoms in the United States are given antibiotics.
The problem with overprescribing antibiotics is bacteria can quickly become resistant, and soon the antibiotics don’t work anymore. Antibiotics can also cause problems like diarrhea or allergic reactions.
How can you tell if your head cold is likely to be a true bacterial sinus infection? It is generally not possible to tell a viral from a bacterial sinus infection in the first 10 days of illness based on history, exam, or even x-rays. However, here are three clues that point to a bacterial, rather than a viral cause:
- Persistent symptoms or signs of sinusitis lasting 10 or more days with no clinical improvement
- Onset with severe symptoms (fever > 102°F and thick, discolored nasal discharge or facial pain) lasting at least three consecutive days at the beginning of illness
- Onset with worsening symptoms following a viral upper respiratory infection that lasted five to six days and was initially improving
Regardless of whether your sinus symptoms are caused by a virus or by bacteria, here are some things that may make you feel better:
- Analgesics like ibuprofen or Tylenol
- Nasal saline irrigation, with saline nasal sprays or a Neti Pot
- Nasal spray decongestants for no more than three days
- Oral antihistamine/decongestants
- Lying on a comfy sofa with a good book, preferably with a nice fire in the fireplace
The next time you get a head cold, this information may help you decide whether you are best served by just waiting it out, or discussing your symptoms with your doctor.
If you do not have your own family doctor, why not call Vantage Physicians? We are a Direct Medical Practice offering our patients same day/next day appointments. For $95 per month, you get your own personal physician, on call, 24/7. We offer traditional office visits where you are seen at your appointed time for 30-60 minutes, telephone calls directly with your physician and email visits. If you are tired of being treated like a number or a disease you will appreciate the doctors at Vantage Physicians, for more information check out our website at VantagePhysicians.net or call us at (360) 438-1161.
