What is acute sinusitis?
Acute sinusitis is an infection of the sinuses.
How long does it last?
It lasts 2-3 weeks and the majority of cases get better on their own.
How do people get acute sinusitis?
Acute sinusitis is commonly caused by a virus. It usually develops after a person catches a cold or viral illness. There are risk factors for developing sinusitis. They are:
- Dental procedures
- Smoking
- Asthma
- Pregnancy
- History of nasal allergy (the inflammation within the sinuses predispose the person to infections)
- Anything that blocks the drainage of the sinuses such as foreign bodies, polyps, previous surgery or injury to the nose and congenital abnormalities
What are the symptoms of acute sinusitis?
The main symptoms are:
- Blocked nose
- Your sinuses are near your cheeks, eyes and forehead so these area may feel tender. This is often worse when you bend forward.
- Temperature
Other symptoms include:
- Toothache
- Yellow/green discharge from the nose
- Reduced sense of smell
- Headache
- Bad breath
- Cough
- Ear fullness
Do I need antibiotics?
The overwhelming majority of patients do not need antibiotics and will get better without them within 2-3 weeks.
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This shows a 100 people with acute sinusitis. Only 2 will have a bacterial infection. The rest have a viral cause for acute sinusitis. That is why antibiotics will not help most people. Antibiotics given in these cases will not help with the symptoms or shorten their duration.
What if I am one of the two people who has a bacterial infection?
Evidence shows that not treating patients in the first 10 days of infection does not lead to harm. As 98% of people get better without treatment it is best to try helping yourself to ease the symptoms. If your symptoms have not improved after 10 days, it may indicate a bacterial infection. However, we take several factors in consideration when deciding if your infection is bacterial. They include:
- Yellow/green or smelly discharge from the nose
- Severe pain over the jaw and teeth
- Ongoing temperature
- If your symptoms initially got better before becoming worse again
What can I treat myself?
- Take paracetamol or ibuprofen for pain or temperature
- Rest and drink plenty of fluids
- Avoid smoking
There is some evidence for cleaning out your nose with saltwater solution. There is also some evidence for using medication to unblock your nose, although you should not use this for longer than week. Ask you pharmacist for further information.
When should I see my doctor?
Although acute sinusitis is a self-limiting condition, in some cases you may need the help of your doctor. Your doctor may reassure you or they may offer you treatment. You should see your doctor if:
- Feel very unwell (this can include sweating and shivering)
- Have a high fever that does not improve with paracetamol or ibuprofen
- You have had previous surgery to your nose or near your nose/eyes/forehead.
- You have not gotten better after 10 days
What treatment do doctors give?
If your symptoms have gone on for longer than 10 days we can:
- Do nothing and wait for your sinusitis to get better on its own
- Give you a course of steroids that you spray into your nose
- In cases where we suspect you may have a bacterial cause we may give you prescription or delayed prescription for antibiotics. This is because in a proportion of patient they get better on their own within a few days.
Further information
NHS Choices: Sinusitis
Patient.co.uk: Acute Sinusitis, Chronic Sinusitis
Clinical Knowledge Summaries: Sinusitis
Local Antibiotic Guidelines for Tameside & Glossop: Acute rhinosinusitis
With thanks to Dr Arif Pardes, GP ST2 June 2021 who helped to produce this resource for patients and carers