Steroids can be helpful in relieving inflammation associated with sinusitis and may be prescribed when symptoms are severe or in the post-operative period. Most commonly, you will be prescribed oral prednisone to take twice a day for 5 to 7 days.
Prednisone, in addition to antibiotics, can lead to resolution or improvement in symptoms at three to seven days.
The treatment for a sinus infection depends on the type of sinusitis and the source of the inflammation or infection. For example, you might need antibiotics to clear up a sinus infection or a short course of steroids like prednisone for sinus infection symptoms.
Corticosteroids work to reduce inflammation and swelling in your sinuses. This makes it easier for nasal mucus to drain into your stomach like it usually does. It also reduces pressure in your sinuses, which helps to minimize pain associated with sinus infections.
The evidence says NO to oral steroids (such as prednisone or methylprednisolone) for acute uncomplicated sinusitis. Oral steroids may help moderately with symptom relief for a few days but the 30 day outcome is the same. Serious adverse events are uncommon however so it is still common practice many places.
Steroid pills and syrups are very good at reducing swelling and mucus production in the airways. They also help other quick-relief medication work better. They are often necessary for treating more severe respiratory symptoms.
Antibiotics, particularly the penicillin-like drug amoxicillin, are among the most commonly prescribed medicines for sinus infections. Steroid sprays sometimes are used, but the study found they also were no better than dummy drugs, although they appeared to provide some relief for patients with only minor symptoms.
There's no treatment for viral sinus infections, but you can manage symptoms with over-the-counter medications. In the rare instance that an antibiotic is needed to treat a sinus infection, amoxicillin or amoxicillin/potassium clavulanate is recommended.
If your sinus infection lasts for about a week, it's usually due to a virus. Bacterial sinus infections, on the other hand, can persist for some time. They usually last for 10 days or longer. While viral infections usually start to get better after a few days, bacterial infections tend to get worse over time.
This may give you the idea that you need antibiotics, but most clear up without them. Antibiotics have no effect on viruses and aren't recommended within the first week of developing a cold. About 70% of sinus infections go away within two weeks without antibiotics.
When you're sick, your doctor may prescribe both an oral steroid and an antibiotic. This is meant to speed up your healing. “The steroid lessens the swelling and inflammation from an infection—for example, swelling in the sinus area in the case of a sinus infection—so the healing will be faster,” says Aaeedy.
Prednisone generally works very quickly — usually within one to four days — if the prescribed dose is adequate to reduce your particular level of inflammation. Some people notice the effects of prednisone hours after taking the first dose.
Use over-the-counter (OTC) medications
OTC decongestants, such as pseudoephedrine (Sudafed), may relieve sinusitis symptoms by narrowing the blood vessels. This helps reduce inflammation and swelling. It may improve the flow of drainage from the sinuses. Shop for Sudafed.
A sinus infection is diagnosed in a physical exam by a primary care doctor, who will look inside your nasal cavity and check for sinus pressure or tenderness by gently touching or feeling your face.
Topical steroids
The fear of using corticosteroids is so common that it has its own name: corticophobia. For topical steroids, this fear stems from well-known and severe adverse effects like Cushing syndrome and permanent skin atrophy.
Side effects of corticosteroids taken by mouth
A buildup of fluid, causing swelling in your lower legs. High blood pressure. Problems with mood swings, memory, behavior, and other psychological effects, such as confusion or delirium. Upset stomach.
Amoxicillin has an average rating of 6.3 out of 10 from a total of 350 ratings on Drugs.com. 52% of reviewers reported a positive effect, while 32% reported a negative effect. Prednisone has an average rating of 7.5 out of 10 from a total of 814 ratings on Drugs.com.
The medication dosage has a big impact on the risk of infection. The infection risk is greatest at high doses (for example, 60 mg of prednisone), “but the risk of serious infection has been found to be approximately doubled even in people taking 10 to 20 mg of prednisone,” says Dr. George.