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Medical Forum / General / General / December 2004Antibiotics for Sinusitis?
Curious if there are any new ones, that work particularly well for sinusitis. I used to be on antibiotics for chronic sinusitis a good part of the year, so I know all the ones that were prescribed as of a few years ago. Since my last sinus surgery in 2002, I have not had as many infections, and have not taken antibiotics much at all. At this moment I cannot remember when the last time was. However, lately I have been sick for a couple of months, worse than my usual rhinosinusitis, and I think I might indeed have a bacterial infection. I see my general practitioner on Monday for a follow-up to a general physical, to check up on results to recent blood tests, not at all related to sinusitis. However, I intend to tell him about it, and ask about the possibility of getting an antibiotic. Therefore, I would like to know if there are any new ones that work especially well for the condition, to suggest to him. Of course, he might not take my suggestion, and he might not want to prescribe an antibiotic at all, as doctors are very reluctant about them these days, with all the publicity about antibiotic resistance. It wouldn't hurt for me to mention any names of them, though, ones that I have taken before and sometimes worked well for me without bad side effects, or new ones I have read about. Therefore, if there is anything new in this area, I would be interested in hearing about it. (Also, with the general reluctance about antibiotics these days, I think they are usually not prescribed for more than ten days at a time, especially by a GP. I think chronic sinusitis often takes longer to completely clear up the infection, no? And isn't it true that if the antibiotic is not taken long enough to clear up the infection, that could increase antibiotic resistance?) Have you ever been on Zithromax (a Z Pack)? > Curious if there are any new ones, that work particularly well for > sinusitis. [quoted text clipped - 30 lines] > long enough to clear up the infection, that could increase antibiotic > resistance?) Yes, I have. Overrated (overmarketed), IMHO. They think that the "Pack" will appeal to people, and once per day dosing. I think Biaxin, which I think is from the same family, worked better for me. Twice per day dosing is fine for me. The antibiotics that require 4 or 5 times per day, now that's a hassle to remember when to take. Twice per day is no problem for me. Also, they usually only prescribe Zithromax in a 5 day pack, because supposedly 5 days of it is as good as 10 days of other types. I'm not sure if that's really true though. And five days is certainly very short for chronic sinusitis, with any antibiotic. It's not new, in any case. Zithromax has been out for several years at least. > Have you ever been on Zithromax (a Z Pack)? > [quoted text clipped - 41 lines] > > long enough to clear up the infection, that could increase antibiotic > > resistance?) > Yes, I have. Overrated (overmarketed), IMHO. They think that the "Pack" will > appeal to people, and once per day dosing. [quoted text clipped - 62 lines] > > > long enough to clear up the infection, that could increase antibiotic > > > resistance?) Zithromax is not indicated for sinusitis. Biaxin is. (You can find this info online if you look for prescribing info for the specific med.) The doctor who just put me on Biaxin for 14 days said exactly what you've indicated, that I might not be totally over the infection in that time, and that I should call her for a refill if it doesn't feel completely gone. I don't know how to tell, but in any case, I think I'll go for her refill. After suffering with multiple sinus infections, year after year, for decades, I experimented with flooding my nasal passages with a mixture of diluted 3% hydrogen peroxide, baking soda and kosher salt. In order to flood my nasal passages and keep them flooded, I keep my forehead pointed downward. I keep my forehead down for quite a while, hoping that the anti-infective mixture can get to the infected area(s) within my sinuses and nasal passages. . It works! I have been sinus infection free for about 3 years. I think that I had chronic infection problems with my turbinates, so flooding my nasal passages with the anti-infective mixture worked very well, for me, since the infected areas were fairly easy to reach. . I have fully documented my experience and how I did it at Healthboards.com. There are posts there by people who have tried my "upside down sinus flooding" and have received either partial relief or total relief. There are also posts there from those who it hasn't helped, and by those who don't think that it is a good idea. I have no connection at all with Healthboards. I use it because I consider it to be the best facility for discussing health problems on the Internet. . To find out more, select one of the following links: . Here is the link to the detailed documentation of the "Upside Down Sinus Flooding" and also discussion: . http://www.healthboards.com/boards/showthread.php?t=139765 . . Here is the link to discussion about the "Upside Down Sinus Flooding" in the Allergy Board: . http://www.healthboards.com/boards/showthread.php?t=129210 . Here is the link to discussion about the "Upside Down Sinus Flooding" in the Colds/Flu Board: . http://www.healthboards.com/boards/showthread.php?t=124803 . . "If you save one life, it is as though you save the world" > Curious if there are any new ones, that work particularly well for > sinusitis. These are claimed to work well for sinusitis: Ketek (telithromycin) (Despite its name, it's a brand new class--ketolide, not a macrolide like Biaxin) Avelox (moxifloxacin) (Another one in the fluoroquinolone family) > (Also, with the general reluctance about antibiotics these days, I think > they are usually not prescribed for more than ten days at a time, especially > by a GP. I think chronic sinusitis often takes longer to completely clear up > the infection, no? And isn't it true that if the antibiotic is not taken > long enough to clear up the infection, that could increase antibiotic > resistance?) Correct on all counts. For chronic sinusitis, a minimum of 3 weeks of antibiotics. Often much longer.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. Thanks for the info, Steve. I think I took Avelox before, a few years ago. I don't recall how well it worked. Never took Ketek. Anyone here who has, or physicians who have prescribed it? How effective has it been for chronic sinusitis? > > Curious if there are any new ones, that work particularly well for > > sinusitis. [quoted text clipped - 18 lines] > For chronic sinusitis, a minimum of 3 weeks of antibiotics. Often much > longer. Took avelox for about a month. Cleared up the sinuses - but left me with gastritis that took 6 months to clear up after that! > Ketek (telithromycin) > (Despite its name, it's a brand new class--ketolide, not a macrolide > like Biaxin) > > Avelox (moxifloxacin) > (Another one in the fluoroquinolone family) > Correct on all counts. > For chronic sinusitis, a minimum of 3 weeks of antibiotics. Often much > longer. Interesting--in looking up both of the above antibiotics, the recommended dosage given for both is once per day for five days. I think many are trying to copy the Z-pack dosage, thinking that patients find that convienent, and come in "packs" of five tablets, etc. As you point out, chronic sinusitis is supposed to have a much longer dosing regimen--but I'm not sure that everyone (including docs) is aware of that. >>Ketek (telithromycin) >>(Despite its name, it's a brand new class--ketolide, not a macrolide [quoted text clipped - 9 lines] > Interesting--in looking up both of the above antibiotics, the recommended > dosage given for both is once per day for five days. That's probably the recommended dosage for "acute maxillary sinusitis." AFAIK, there is no FDA-approved dosage for chronic sinusitis, for any antibiotic. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > AFAIK, there is no FDA-approved dosage for chronic sinusitis, for any > antibiotic. Probably true, but many docs don't know about the long courses for chronic sinusitis. With the meds that come in the five pill "pacs", they will most likely prescribe one such "pac". Anyhow--I saw the doc today, and he prescribed Cefzil, 500 mg, twice per day. I don't recall if I have ever taken that one before. When I used to be on antibiotics frequently for frequent prolonged infections, those I was on the most were Biaxin (clarithromycin), the various flouroquinolones, and a few times Augmentin (amoxicillin-clavunate). I might have been prescribed Cefzil sometime before, but I don't recall it. Have others (both patients and prescribers) found that to be a very effective one for chronic sinusitis? He prescribed it for two weeks, but with one refill, so it will be possible to take for a month if necessary. |
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