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Medical Forum / Diseases and Disorders / Sinusitis / November 2005When to go the antibiotic route?
Hi All, Does anyone have any rules of thumb as to what point to resort to antibiotic treatment? We had a cold front move in the area yesterday (35-40 degree swing) and I'm guessing the change in barometric pressure is wreaking havoc on my sinuses. Frontals are closed/semi-closed and a moderate amount of green mucus is now being produced. I've had what I deem a successful FESS (5 months ago) to open up the ethmoids and maxillaries. I know I could go to my GP and get some antibiotics, but I don't want to resort to them if not necessary. My current regimen to combat this is: ibuprofen, pseudoephedrine decongestant, 3 irrigations/day (some with alkalol), megadosing vitamin C, rest, eating smart. Any thoughts? Thanks. > Hi All, > [quoted text clipped - 12 lines] > > Any thoughts? Thanks. Sometimes it takes a few days for your sinuses to adjust to radical weather changes. Sounds like you are doing all the right things except maybe add drinking hot tea to your routine. I went thru the same thing about 6 weeks ago thinking I had a new infection coming on after a big weather change and it turned out to just be a period of adjustment and not a new infection. If you have had chronic sinusitis for a long time and then finally get used to breathing semi-normally for a while, it's easy to freak out when you think you are again plugging up. Been there, done that. Also, when I turn on the winter heating it takes a while for my sinuses to adjust. AW I totally agree about 'jumping the gun' and easily freaking out when getting plugged up. After getting the upperhand on a bad bout of chronic sinusitus due to undertreatment, I am really paranoid about getting back in that situation again. On the flipside, I don't want to resort to any more antibiotics then necessary since I took way more than my share during my battle with chronic sinusitis. The good news is that I turned the corner and feel as if i'm getting better. That gives me renewed faith that my FESS opened up my sinuses enough to permit my own immune system to handle the bacteria/virii. Thanks. > I totally agree about 'jumping the gun' and easily freaking out when > getting plugged up. After getting the upperhand on a bad bout of [quoted text clipped - 6 lines] > better. That gives me renewed faith that my FESS opened up my sinuses > enough to permit my own immune system to handle the bacteria/virii. One more point: My ENT believes that a patient who undergoes FESS can be at increased risk for viral and other infections for a while. The reason is that the FESS scraped the sinus linings and it will take time for the cilia to regenerate. (The cilia are supposed to sweep germs away before they can start an infection.) So you shouldn't be surprised you got an infection. But if the FESS worked, the symptoms of the infection should be milder and the infection should clear faster. Hang in there and be patient.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. On 11/13/05 7:24 PM, in article 7sTdf.1427$c27.986@newsread3.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: > One more point: My ENT believes that a patient who undergoes FESS can > be at increased risk for viral and other infections for a while. The > reason is that the FESS scraped the sinus linings and it will take time > for the cilia to regenerate. Its more like after any nasal/sinus surgery the cilia are impaired. Trick is to get the cilia back working again ASAP, which is why pulsatile irrigaiton is recommended after sinus surgery. My rule of thumb to go to the doctor is- a few days of useing tylenol, saline rinse or any self-help that helped in the past does not work. Then I go to the doctor for some Meds. shirley > Hi All, > [quoted text clipped - 10 lines] > decongestant, 3 irrigations/day (some with alkalol), megadosing vitamin > C, rest, eating smart. Based on what my own ENT told me: My rule of thumb is that when the mucus turns green or brown (not just yellow-green), and persists for more than 3 weeks, it's time to consider antibiotics. A bacterial or viral sinus infection can be self-limiting, especially if the sinus surgery was successful and the sinuses are wide open now. Sometimes it will go away after a few weeks with irrigation and rest. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. Hi Steven, I'm curious as to your distinction between greenish-yellow versus green/brown mucus. I always assumed that the yellow-green is a combination of white blood cells and bactera/virii. Does a darker color indicate a higher proportion of 'bad guys' versus 'good guys'? Thanks. > Hi Steven, > > I'm curious as to your distinction between greenish-yellow versus > green/brown mucus. I always assumed that the yellow-green is a > combination of white blood cells and bactera/virii. Does a darker > color indicate a higher proportion of 'bad guys' versus 'good guys'? The green color is due to chemicals secreted by neutrophils, the defensive white blood cells. The worse the infection, the more neutrophils are being produced by your body in response to it. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. You've obviously done your research. So, what does a brown color indicate? At one point I assumed the brown was partly dried blood, but I've seen conflicting reports as to that. Is it just an overwhelming amount of neutrophils? Or possibly some amount of dead bacteria? Also, since you seem to know about these things: Is the 'goal' of the body to capture the bacteria/virii in the sinus and nasal passages because it can better combat them there (provided your sinusus are healthy and anatomically correct)? Thanks.
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