How can you tell if you have a self-limiting sinusitis from a virus versus a full blown bacterial sinus infection? Only time will tell, literally. The symptoms are similar between the two, and X-rays and CT scans can’t differentiate acute bacterial rhinosinusitis from a viral rhinosinusitis.
The difference viral and bacterial sinus infections becomes obvious when the viral infection resolves in 7 to 10 days but the bacterial infection continues to produce symptoms that last beyond 7 to 10 days, or worsen after 5 days.
If you have a true bacterial infection of your sinuses there is no otc medication that will treat your infection. Of course, there are a number of otc treatments that will help with the symptoms and may help your body clear the infection faster.
This article will discuss some of the otc treatments that are helpful for sinus infection symptoms. However, a true sinus infection should be diagnosed by a physician and treated with antibiotics. This point is firmly emphasized because an untreated bacterial sinus infection can extend into your brain. This can cause meningitis, brain abscesses, orbital cellulitis, and cavernous sinus thrombosis.
Additionally, bacterial sinusitis can develop into a chronic sinusitis if it is not treated appropriately. The usual treatment is amoxicillin, augmentin, trimethoprim/sulfamethoxazole, a 2nd generation cephalosporin, a macrolide or a quinolone antibiotic for 10 days.
Over-the-counter treatments that provide some relief while your body eliminates sinus infections include:
-Topical decongestants: Use decongestants for one week at the very most to avoid rebound congestion when you discontinue this medication.
-Sinus washes: You can buy saline nasal sprays but they aren’t as effective as neti pot style sinus rinses. You can make your own saline water by mixing 1 cup of tepid-warm water with a 1/2 tsp of sea salt. Clean your sinuses two times a day.
-Antimicrobial nasal sprays: Most of these have grapefruit seed extract in them. These may or may not be effective, the research is inconclusive. If you choose to use a natural antimicrobial nasal spray, use it after you have rinsed your sinuses as described above.
-Support your immune system while your sick: Eat your veggies and fruits, get enough sleep and consider supplements. Goldenseal tincture is one of my favorites as it supports the immune system and has antimicrobial properties, but note that it may cause hypotension (low blood pressure) if taken for more than 2 weeks. Elderberry, also called Sambucus nigra, is another excellent choice for immune boosting. Zinc, Vitamin D and Vitamin A may also be helpful. Be careful not to take too much Vitamin A which can be toxic.
With these supportive measures a viral sinus infection will pass in 7 to 10 days. For a sinus infection that has been hanging around more than a week, seek the attention of your physician and keep up the otc sinus treatments. An acute bacterial sinusitis should resolve in 2 to 3 weeks.