Amoxicillin for sinus infection

Amoxicillin belongs to penicillin antibiotics and is used in range of infections. It can be administered either orally or intravenously. Amoxicillin is also available in a form of a nasal spray. This is a highly effective antibiotic against many bacteria. One of the infections that is treated with amoxicillin is sinus infection.

Amoxicillin and Sinus Infection

Sinus infection is a common infection and it affects people of all ages. It can occur once (acute sinus infection) or tends to reoccur when it turns into a chronic form. Sinus infection caused by bacteria does not respond to home remedies and requires proper antibiotic treatment. One of antibiotics prescribed in patients suffering from sinus infection is amoxicillin. The drug is very effective and can successfully eradicate harmful bacteria. It also does not have many side effects. Amoxicillin is forbidden in patients who are allergic to the medication or any other penicillin drug.

Only in case the patient does not respond to treatment with amoxicillin this points to the resistance of the bacteria to the drug and it needs to be replaced with some other antibiotic.

Most guidelines recommend amoxicillin with or without clavulanate as a first-line antibiotic for adults because of its safety, effectiveness, low cost, and narrow microbiologic spectrum. Amoxicillin/clavulanate (Augmentin) should be used in patients who are at high risk of bacterial resistance or who have comorbid conditions, as well as in those with moderate to severe infection.

Respiratory fluoroquinolones are not recommended as first-line antibiotics because they conferred no benefit over beta-lactam antibiotics and are associated with a variety of adverse effects. According to a recent U.S. Food and Drug Administration safety alert, fluoroquinolones should be reserved for patients who do not have other treatment options. Macrolides, including azithromycin (Zithromax), trimethoprim/sulfamethoxazole, and second- or third-generation cephalosporins, are no longer recommended as initial therapy for acute bacterial rhinosinusitis because of high rates of resistance in S. pneumoniae and H. influenzae.
The recommended duration of therapy for uncomplicated acute bacterial rhinosinusitis is five to 10 days for most adults. This recommendation is based primarily on findings from a meta-analysis of 12 randomized controlled trials.
A shorter treatment course (median of five days) may be just as effective as a longer course of treatment (median of 10 days) and is associated with fewer adverse effects. Regardless, clinicians should assess disease and symptom response before stopping antibiotic therapy prematurely, especially in older adults and in patients with underlying disease.
Treatment failure occurs when a patient's symptoms do not improve by seven days after diagnosis or when they worsen at any time, with or without antibiotic therapy. If treatment failure occurs following initial antibiotic therapy, an alternative antibiotic with a broader spectrum is required. High-dose amoxicillin/clavulanate, a respiratory fluoroquinolone, or the combination of clindamycin plus a third-generation oral cephalosporin may be considered.

These therapies may be used to treat symptoms within the first 10 days of upper respiratory infection. Radiography is not recommended in the evaluation of uncomplicated acute rhinosinusitis. For patients who do not respond to treatment, computed tomography of the sinuses without contrast media is helpful to evaluate for possible complications or anatomic abnormalities. Referral to an otolaryngologist is indicated when symptoms persist after maximal medical therapy and if any rare complications are suspected.

✓ Fact confirmed: Current Concepts in Adult Acute Rhinosinusitis Ann M. Aring, MD and Miriam M. Chan; 2016 Jul 15

Amoxicillin Dosage for Sinus Infection

The single dose for adults in case of sinus infection is 500 mg. The drug is taken 3-4 times a day (1500-200 mg of amoxicillin per day). The entire length of the treatment depends on the patient's general health, age, comorbidities and the severity of the sinusitis.

The standard treatment last up to 10 days. During this period of time the patient's state improves and symptoms and signs of the infection gradually withdraw. In case they linger and one does not feel better the doctor may chose to replace the medication with some other antibiotic.

It may happen that people who are prescribed amoxicillin do not finish the course of antibiotics and stop taking the drug once they start feeling better. It is not good to stop with the treatment without consulting a doctor. The cease in treatment carries risk of recurrence of the infection.

In case of chronic sinusitis patients may be prescribed lower doses of the drug and the drug is taken for longer period of time (for example 4-6 weeks).

In case amoxicillin is taken in a form of capsules they are not supposed to be chewed. They are simply swallowed and once they enter the specific part of the intestine they dissolve and are absorbed. One more important thing is to inform the doctor about all the conditions one is suffering from, all the possible allergies as well as medications that are taken or regular bases.