The best medicines and antibiotics for sinusitis, description and price. Principles of effective antibacterial therapy of sinusitis in adults and children How to treat bacterial sinusitis in adults drugs

Inflammatory processes in the paranasal sinuses are one of the most common pathologies of the upper respiratory tract. Among patients of otorhinolaryngological hospitals, the percentage of diagnosis of acute and chronic sinusitis is about 40%.
The concept of sinusitis means an inflammatory lesion of the paranasal sinuses of various etiologies (bacterial, viral, fungal, allergic).

An interesting fact is that even with the viral nature of inflammation, a secondary, bacterial component can later join. Therefore, antibiotics for the treatment of sinusitis in adults and children are recommended to be prescribed from the first days of the disease.

The high risk of severe complications necessitates early antibiotic therapy. At the initial stages of treatment, antimicrobial agents are selected empirically, taking into account the main pathogens.

Which antibiotic is better for adult sinusitis for an alternative regimen?

Inhibitor-protected penicillins with antipseudomonal activity;
cephalosporins (Cefuroxime ® , Cefotaxime ® , Ceftriaxone ® , Cefepime ® , Ceftazidime ® , Cefoperazone ®);
def. cephalosporins (Cefoperazone/Sulbactam®);
fluoroquinolones (Ciprofloxacin ® , Levofloxacin ®);
carbapenems (, Meropenem ®), are prescribed for severe infections with a high level of drug resistance;
macrolides, preferably used for beta-lactam allergy in pregnant women.

It is highly effective against Gramflora, does not affect Pseudomonas aeruginosa, PRSA, which produce staphylococcal penicillinase. Weakly active in infections associated with streptococci, anaerobes, penicillin-sensitive staphylococci.

Side effect from the use:

• ampicillin rash;
• individual intolerance and allergic cross-reactions to other beta-lactams.

Contraindications:

• liver disease;
• individual hypersensitivity;
• age up to a month;
• pregnancy;
• use of oral anticoagulants.

It is administered parenterally at the rate of two to six grams per day, divided into four injections.

For oral administration, 500 mg every six hours, one hour before meals (adults).

For children, 50-100 mg / kg per day is used, divided into 4 injections. Orally consumed at 30-50 mg / kg, every six hours.

The best antibiotic for sinusitis in adults for endonasal use

Local therapy is effective if the agent used can penetrate through the fistula of the nasal passages, directly into the inflammatory focus and have a direct effect on the pathogen. In case of complete obstruction of the nasal passages, such treatment will not be appropriate until restoration of at least partial aeration of the sinuses.

Common sprays and drops with antibiotics for the treatment of sinusitis: name, composition, application

Isofra ®

Means for local use in ENT practice. It is produced in the form of a spray. The active active ingredient is an antibiotic (hereinafter referred to as ABP) of a series of aminoglycosides-framycetin.

This tool is able to create effective concentrations in the mucosa of the paranasal sinuses. It has minimal systemic absorption, that is, it practically does not enter the bloodstream.

It has a pronounced bactericidal effect on most Gram- and Gram + pathogens, has low flora resistance and rare side effects.

Isofra is not prescribed to patients with individual intolerance to framycetin or allergy to aminoglycosides. Not for use in children under one year old.

Adults use the drug up to 6 times a day (children up to three times), one spray in each nasal passage.

Exceeding the duration of the course is not permissible, due to the risk of developing superinfection and the emergence of drug-resistant strains.

The spray is prohibited for use in women during pregnancy, due to the risk of toxic effects on the cochleovestibular apparatus of the unborn child. Also, it is contraindicated during breastfeeding!

Rinil ®

What antibiotic is better to use for sinusitis if there is no Isofra ® in the pharmacy? Similar in its action and active substance (framycetin) is Rinil ® .

The drug is available in the form of drops and spray. Dosages and duration of use are similar to Isofra.

The high efficiency of framycetin is due to a wide spectrum of action on pathogens of diseases of the upper respiratory tract. It has a bactericidal effect, even on beta-lactam resistant strains.

Some streptococci, anaerobes, treponema are resistant.

Due to the low systemic absorption, it does not exhibit the ototoxic effect characteristic of aminoglycosides when administered orally or parenterally.

Polydex with phenylephrine ®

The drug most often offered in pharmacies, after the question: what antibiotics in the form of a spray are better to treat sinusitis?

The high efficiency of the product is due to its combined composition.

Two antibacterial components (- natural polypeptide and, a representative of the series), have a pronounced antimicrobial effect. The combination of polymyxin and neomycin significantly expands the spectrum of activity on the pathogenic flora. Glucocorticosteroid hormone (dexamethasone ®) has an anti-inflammatory and vasoconstrictive effect, reducing the degree of swelling of the mucous membrane, restoring normal aeration of the sinuses and reducing exudate production. Phenylephrine ® refers to alpha1-adrenergic stimulants, has a strong vasoconstrictor effect.

The low systemic absorption of Polydex ® components, in combination with dexamethasone (which has an anti-allergic effect), causes a low incidence of side effects from the use.

It is important to remember that Polydex ® spray is contraindicated for use in persons:

• with a disease of the upper respiratory tract of viral etiology;
• with angle-closure glaucoma;
• pathology of the kidneys with albuminuria;
• kidney failure;
• children under 2.5 years old;
• pregnant and lactating women;
• with pathology of the thyroid gland;

How to use the spray?

Patients over fifteen years of age and adults use Polydex ® one injection in each nasal passage, up to five times a day.

Children from 2.5 to fifteen years old, one dose in the nasal passages, up to three applications per day.

Bioparox ®

The active substance that provides antimicrobial action is a natural polypeptide ABP of fungal origin - fusagungin.

A well-adapted spectrum of activity makes it effective against most representatives of Gram- and Gram+ flora, anaerobes, mycoplasmas and some molds. Also used against actinomycetes and Candida.

Powerful, local anti-inflammatory and antimicrobial activity allows using Bioparox not only at the stage of catarrhal inflammation, but also in the presence of a block in fistulas, as an effective means of additional therapy.

It has no systemic absorption into the bloodstream.

As a rule, it is well tolerated by patients, but it is not recommended for long-term use, due to the risk of drug-resistant flora and the possibility of developing atrophic changes in the mucous membrane.

As side effects are possible:

• asthma;
• broncho- and laryngospasm;
• hives;
• perversion of taste sensations;
• bad taste in the mouth.

Not applicable for treatment:

• patients younger than 2.5 years;
• pregnant women;
• breastfeeding.

Dosages and frequency of use

For children over twelve years old and adults, use two doses of the drug in each nostril, up to four times a day. Up to twelve years, use one dose four times a day.

Antibiotics for sinusitis in children

This pathology in children of the first years of life, as a rule, does not occur, due to the unformed sinuses. Therefore, the main antibacterial sprays and drops for topical use are suitable for both adults and children.

It is important to remember that Rinil ® is not prescribed until the age of one, and is not used in babies under 2.5 years old.

For systemic administration, it is preferable to use protected penicillins and cephalosporins, in case of allergy to beta-lactams - macrolides.

Treatment of sinusitis without antibiotics

Treatment of this disease without antibiotics is not recommended.

As additional stages of therapy, the use of: decongestants, antiallergic drugs, mucolytics, NSAIDs, multivitamins is effective.

Physiotherapeutic procedures are also applied. Surgical treatment is indicated in the absence of positive dynamics from the ongoing treatment and a progressive deterioration in the patient's general condition.

Decongestants

Oxinmetazoline ® preparations are used:

• Nazivin ® ;
• Knoxprey ® ;
• Nazol ® .

Xylometazoline:

• Rhinorus ® ;
• Otrivin ® .

Nafazalina:

• Naphthyzin ® .

Phenylephrine:

• Nazol Baby ® ;
• Irifrin ® ;
• Mezaton ® .

Sprays that thin the discharge and facilitate its discharge

Rinofluimucil ® is a combined agent of acetylcysteine ​​and thiaminoheptane. Helps eliminate swelling of the mucosa, reduce exudation, thin the discharge and facilitate its discharge.

Anti-inflammatory drugs, with tropism for the respiratory tract

Erespal ® significantly improves mucociliary transport, reduces the viscosity of the mucous secretion and reduces its amount, eliminates edema and normalizes aeration.

Non-drug treatment

Phys. procedures are effective as part of the complex therapy of chronic forms. Assign electrophoresis with ABP, phonophoresis with hydrocortisone and its combination with oxytetracycline. The impact of microwave and ultrasonic waves on the sinuses, irradiation with a helium-neon laser is effective.

It is highly effective to wash the nasal cavity by moving the liquid along the Proetz (cuckoo).

With difficult evacuation stalemate. contents from the maxillary sinuses, a puncture is shown, with further washing with antiseptics, shunting.

Surgical tactics are used in the presence of intracranial or ocular complications, as well as in chronic forms of the disease. Microgeneral sinusectomy is performed using special trocars or extranasal opening according to Caldwell-Luc.

Bacterial sinusitis requires the use of antibiotics. Unlike other medicines, they destroy the main cause of the disease, and the person recovers faster. To understand which antibiotics are the best, you need to familiarize yourself with their characteristics.

Only an otolaryngologist should select an antibiotic and dosage regimen, taking into account the course of the disease and the results of diagnostic studies.

Antibacterial medicines are prescribed if sinusitis is accompanied by the following symptoms:

• pain in the eye sockets and frontal lobes;
• feeling of pressure in the nose and forehead;
• an increase in body temperature (a symptom characteristic of an acute form of sinusitis);
• copious discharge of purulent fluid from the nasal passages;
• violation of nasal breathing;
• headaches that do not go away even after taking strong painkillers;
• discomfort in any part of the head when tilted to the side or side.

At the first sign of sinusitis, you should consult a doctor. If the pathology is not treated, then dangerous and unpredictable complications can develop that can affect the brain. Antibacterial therapy is indicated when other treatments have failed. Antibiotics for sinusitis are most effective after 7 days from the onset of the disease.

What antibiotics are effective for sinusitis

To avoid complications with sinusitis, treatment with antibacterial medicines should not be ignored. Which antibiotic is more effective, the specialist knows.

Protected aminopenicillins

A group of synthetic medicines that contain an additional substance that destroys bacteria. Once in the body, they begin to actively fight the infection.

Effective protected penicillins against sinusitis:

• Unazine, Sulacillin, Ampisid, Sultasin - ampicillin sulbactamates;
• Amoxiclav, Flemoklav, Augmentin, Rapiclav - amoxicillin clavulanate.

Such penicillins are widely used. They act targeted, destroying only pathogenic pathogens, without destroying healthy cells. Can be taken for sinusitis in adults and children. But long-term use can provoke allergies and microflora disturbance.

Macrolides

Macrolides are antibiotics that are often prescribed if the infection has not been defeated by other antibacterial agents. Their pharmacological action is due to the ability to penetrate into microbial cells, disrupting protein synthesis.

Macrolides include the following drugs:

• Macrofoam;
• Azithromycin;
• Zitrolide;
• Josamycin;
• Clarithromycin.

Medicines of the macrolide group are considered the safest for the human body among all antibacterial agents. But, despite this, they can still cause some side effects from the systems and organs, such as headache, nausea, diarrhea, and vomiting. They should be carefully prescribed for diseases of the liver and kidneys.

Cephalosporins

The structure of cephalosporins resembles penicillin, but they are more resistant to pathogenic microorganisms. There are 5 generations of antibiotics in this group, which have their own spectrum of action.

Effective cephalosporins of different generations:

• Cefuroxime;
• Cefixime;
• Cefazolin;
• Zinnat;
• Cefutil;
• Cedex and others.

These antibacterial drugs are used to treat sinusitis of any form. Doctors prefer third-generation cephalosporins. With extreme caution, they should be used by patients prone to allergic reactions.

Fluoroquinolones

The drugs in this group are completely synthetic. They have a wide bacterial spectrum, therefore they have a pronounced and rapid bactericidal effect on almost all pathogens of sinusitis.

Fluoroquinolones are divided into 4 generations. Common drugs of the group:

• Tarivid;
• Abaktal;
• Tsiprolet;
• Ecocyfol;
• Normax;
• Levostar;
• Respara;
• Moxin;
• Fact.

Due to their artificial origin, they are highly toxic. Often lead to allergic reactions and severe side effects from the nervous system and gastrointestinal tract. Therefore, they are contraindicated for the treatment of children, pregnant and lactating women.

Pros and cons of antibiotics for sinusitis

An effective antibiotic for sinusitis is prescribed taking into account the result of the analysis of a swab from the nose. To avoid negative consequences, when choosing a drug, the doctor takes into account its advantages and disadvantages.

Ceftriaxone for sinusitis

Ceftriaxone belongs to the cephalosporin antibiotics and is a 3rd generation drug. It has a powerful effect on most pathogenic microorganisms. It is often chosen for the treatment of not only sinusitis, but also other infectious diseases of the nasopharynx.

High efficiency is the main advantage of the drug. Under the influence of Cefritaxone, the reproduction of bacteria is suspended. A positive result in sinusitis (complicated course) will be achieved faster if Ceftriaxone is administered intravenously.

The main disadvantages of Cefritaxone lie in a large number of side effects. Doctors often see:

• gastrointestinal disorder;
• angioedema;
• hepatitis;
• interstitial nephritis.

It is strictly forbidden to take during pregnancy and lactation.

Augmentin (Amoxiclav) from sinusitis

This drug has a powerful bactericidal effect and can be taken not only by adults, but also by children. For each age category of patients, a dosage is selected, which is an indisputable advantage of the drug.

Augmentin is a safe and modern antibiotic that has proven itself in the treatment of sinusitis. Today, the drug is considered the most effective against most pathogens, so it easily copes with their resistance.

Another advantage is the selective bactericidal effect. In the process of treatment with Augmentin, only pathogens are destroyed, while healthy cells and tissues are not affected. To achieve a therapeutic effect, it is enough to take the medicine 2 times a day.

All the disadvantages of the drug lie in the possible side effects. Often, nausea and heartburn appear during treatment, damage to the kidneys and liver is observed.

A common analogue of Augmentin is Amoxiclav with an identical composition.

Sumamed from sinusitis

Sumamed belongs to the group of drugs-macrolides. The drug is valued all over the world for its high quality and effectiveness in the treatment of complex bacterial infections.

The main advantage is a wide range of action. The drug is effective against most bacteria. Softly acting, Sumamed stops the development of colonies of pathogens. Another advantage is the short course of therapy. This drug accumulates well in the body and acts for a long time.

Sumamed has a small risk of side effects compared to other antibiotics. Only 10% of patients report malfunctions in the gastrointestinal tract and nervous system. Allergies during treatment rarely occur.

The main disadvantage of the drug is associated with its contraindications. Sumamed should not be taken by children under 12 years of age, pregnant and lactating women, and people with certain chronic diseases.

Macropen from sinusitis

Macropen belongs to the latest generation of macrolides. The drug is low-toxic and effective against many pathogens of sinusitis.

The ability to quickly penetrate into blood cells is the advantage of this antibiotic. The therapeutic effect occurs 1 hour after ingestion. But the elimination period is short, so take the drug 3 times a day.

The risk of side effects is minimal. In rare cases, patients complain of headache, nausea, urticaria, insomnia. But even with a long course of treatment, undesirable consequences develop only in 4% of cases.

The disadvantages include restrictions on the use. So, Macropen can not be taken in diseases of the liver and kidneys.

Flemoxin Solutab from sinusitis

The drug Flemoxin Solutab belongs to the group of penicillins. The undeniable advantage of the drug is resistance to gastric juice and high efficiency. This fact guarantees that the antibiotic will not cause significant harm to the body. The gastrointestinal tract suffers little from its impact.

The maximum concentration in the blood is reached quickly, so the therapeutic effect occurs immediately.

The disadvantages of this antibacterial agent include a contraindication to the use of elderly people, patients with renal insufficiency.

Isofra with sinusitis

Isofra refers to topical products, which are produced in the form of a spray. The antibiotic of the aminoglycoside series-framycetin is the active substance of the drug. After application, the antibiotic is concentrated in the mucous membranes, providing a therapeutic effect there. It has minimal absorption, i.e. practically not absorbed into the systemic circulation.

Against the background of treatment, side effects do not appear, which makes it possible to prescribe the drug to children older than 1 year. Ease of use is also one of the advantages of the tool. The desired dosage can be obtained with one click by spraying into the sinuses.

The disadvantage of Isofra is the narrowness of the spectrum of action. The active substance of the drug is not able to affect many bacteria. Therefore, it is advisable to treat sinusitis with a spray for 7-10 days. If a positive result is not achieved, then other antibacterial agents should be resorted to.

Dioxidine for sinusitis

Dioxidine is an antibiotic with a wide range of uses. The causative agents of sinusitis do not withstand the effects of the drug and die. Produced in the form of a solution in ampoules, which is instilled into the nasal cavity. It has long and effectively been used to treat infectious diseases of the ENT organs.

The main advantage is topical application, which leads to rapid sanitation of the nasal mucosa. The relatively low price (about 50 rubles) is the second advantage.

Dioxidine is considered toxic. The active ingredient is able to enter the bloodstream through the nasal mucosa, causing undesirable consequences. The drug should not be prescribed to patients under 18 years of age, pregnant and lactating women.

With the help of Dioxidin, sinusitis cannot be completely cured. Therefore, it should be used in complex antibiotic therapy.

For effective treatment, an antibiotic must be prescribed by a doctor. Recovery depends on the patient's compliance with all recommendations. These include the following:

• do not reduce (increase) the dosage selected by the doctor;
• you need to take the medicine strictly on time;
• with positive dynamics, it is impossible to interrupt the course of treatment;
• no need to take additional medications without consulting a specialist;
• it is forbidden to drink alcohol and drugs during the period of treatment;
• for preventive purposes, the intake of prebiotics is indicated, which protect the intestinal microflora;
• you can not choose antibiotics on your own.

What happens if you don't take antibiotics

If left untreated, sinusitis can develop complications that threaten a person's life. The dangerous consequences include:

• meningitis;
• abscess;
• loss of smell;
• inflammatory process in the facial nerve;
• spread of infection through the respiratory system;
• eye inflammation.

Possible side effects after taking

Antibacterial therapy can not only get rid of sinusitis, but also lead to a number of side effects. With adequate selection of the drug and dosage, undesirable consequences can be avoided. But the doctor is still obliged to warn the patient about the following side effects:

• swelling of the throat and face;
• redness of the skin or rashes on the skin;
• discomfort in the nasal cavity (after using Isofra or Polydex);
• labored breathing;
• dizziness, fainting;
• disruption of the gastrointestinal tract.

If any symptom occurs, you should seek medical help, you can not self-medicate.

Sinusitis is an inflammatory process of the maxillary sinuses, which can be safely attributed to a traumatic allergic virus that spreads bacteria. Its development is often associated with a prolonged cold or flu. Therefore, the best way to recover is to take antibiotics for sinusitis.

Before you start using an antibiotic for sinusitis, it is necessary to diagnose:

1. Tank-sowing and its causative agent (to understand the nature of the disease, as well as the variety of microorganisms, as a result of which purulent sinusitis developed).
2. Antibiogram (a new procedure for determining the sensitivity of microorganisms to antibiotics). When the diagnosis is completed, the doctor will prescribe the appropriate drug for the disease.

Treatment of the disease should be started if the patient:

1. Pain in the eye sockets and frontal lobes.
2. Constrictive feeling in forehead and nose.
3. High body temperature (we are talking about the acute form of purulent sinusitis, since there will be no fever from a chronic patient).
4. Significant amount of excreted pus.
5. Difficulty breathing through the nose, especially at night.
6. Systematic migraines, symptoms of sinusitis, which are not relieved even by potent medications.
7. By tilting the head to the sides or sides, the patient is hurt and uncomfortable every time. He feels pressure on certain parts of the face.

If timely therapeutic treatment is refused, the disease can not only become chronic, but also negatively affect the human brain. The final may have irreversible complications and outcome.

7 days after the manifestation of the pathology, the doctor decides to prescribe antibiotic therapy. It is carried out when neither inhalation procedures nor nasal lavage have brought any effective effect.

Only a specialist can prescribe medication. Self-medication is excluded, since antimicrobial types of medicines can provoke the development of side effects, such as otitis media, bronchitis, and others. Their consequences will be irreparable.

Any methods of treating the disease should be aimed at achieving:

1. Get rid of inflammation in the sinuses.
2. Increased outflow of secretions from the nose, which were formed due to the inflammatory process.
3. Reduced swelling of the mucous membranes of the sinuses and nose.
4. Minimizing pain.

REFERENCE: it is possible to recover from sinusitis only under the supervision of the attending physician. You can't heal on your own!

According to the standard, the disease is treated with medication. Doctors resort to surgery only when other options have not brought the desired result.

If the inflammation began due to the development of pathogenic microflora, antibacterial drugs are used. They actively contribute to the relief of the disease of the nasopharynx, but their minus lies in the possible harm to the patient's gastrointestinal tract. Especially if you use them for a long time period.

The use of this kind of medicine has many other disadvantages:

1. Pathogenic microorganisms quickly "get used" to antibacterial substances.
2. Today, the markets produce a huge number of fakes.
3. If the patient is faced with a problem with normal circulation, antibiotics begin to act less effectively.

In addition, medications of this effect are usually not to be taken during pregnancy and breastfeeding.

Without drugs, it is possible for both children and people of more advanced age, because there are many different folk recipes.

When the disease has just begun to progress, you can:

• with saline solution, sea salt or a decoction of herbs. Repeat rinsing should be about 4 times a day;

REFERENCE: do not carry out the procedure for washing the nose if at least one nostril is clogged! In such a situation, the puffiness must first be removed.

• drainage of the paranasal sinuses is effective in the disease. The nasal passages need to be moistened with a herbal medicinal solution (you need to use pre-moistened cotton swabs, holding them in the nose at a 1-centimeter depth for 5 minutes). Every 2 minutes it is necessary to easily turn them, then again leave them in a stationary position. When this is done, it is worth forcibly blowing the air out of the nostrils, then cover the nose and mouth with the help of hands and take a strong breath through the nose. To prepare a herbal decoction, St. John's wort, chamomile, cedar and gum solution are taken in a ten percent proportion;

• in the absence of a violation of the outflow of green mucus from the sinuses, at night inside the nose can be lubricated with a warming ointment containing tetracycline.

The above procedures in the complex should be done in the evening every day for a week.

When there is no possibility of drug treatment, the specialist will most likely prescribe Sinupret tablets. This antiviral medicine for sinusitis, which has a mild effect on the human body, helps to increase immunity.

Also today, medical clinics offer to treat nasopharyngeal disease without antibiotics in the following ways:

• carry out laser therapy;
• ozone therapy treatment;
• holding a nasal shower;
• sanitation without the need for punctures;
• washing the sinuses of the upper jaw using appropriate medical drainage.

If conservative treatment has not been effective, paranasal. Due to the puncture, the patency of the anastomosis, which is the link between the nasal cavity and the sinus of the upper jaw, is restored.

In parallel with the injection, there is an option to thoroughly rinse the inside of the nose and introduce special preparations.

It happens that the disease, not having a fungal or allergic pathogen, has the most negative effect on the patient, rapidly progressing.

Then it is worth resorting to the use of anti-inflammatory antibiotics.

At what symptomatology can the doctor prescribe this or that drug?

1. Persistent sharp pain in the nose.
2. Increase in body temperature.
3. Deterioration of the well-being of a person as a whole due to severe intoxication.
4. Pus from the nasal cavity.
5. Strong migraines.

Sometimes antibiotics are not used. But if the patient's condition continues to deteriorate and the pain does not go away, you should be treated with modern varieties of medicines for sinusitis in the form of dragees, sprays or punctures.

The effectiveness of sinusitis tablets for the younger generation manifests itself two days after the treatment process has been started.

The temperature should return to normal, the main symptoms should disappear, the migraines will also stop, and the child will generally feel better.

Now manufacturers produce medicines of different forms of release for children. The final decision is made by the attending physician after assessing the general condition of the child and the properties of the most optimal antibiotic options:

1. Drops and sprays for internal use(the cheapest way). They are recommended for use with a long-term inflammatory process, when it all comes down to the fact that sinusitis will eventually develop. Children are prescribed the drug 1 dose in each nostril 3 times a day. Babies under the age of one year are not prescribed sprays.
2. Capsules and dragees. They are used as soon as the first symptoms and complaints appear. Doses and duration of administration are determined depending on how old the child is. They are appointed from the age of six to seven years of age. Younger children simply won't be able to physically swallow a dragee. In addition, there is a risk that an allergy to the components of the tablets will develop.
3. Suspensions. These packages with the presence of a powder inside are just as effective as dragees. In this form, an antibacterial agent is used to treat very young babies. They are diluted with warm purified water. The dosage must be found in the instruction manual, which is included as standard. You should also focus on the weight of the child.
4. Punctures. Their introduction is resorted to if the form of sinusitis has become very aggravated, and all other procedures are ineffective. The drug is absorbed into the blood, bypassing the gastrointestinal tract. It has an effective bactericidal effect. It is so effective that the result can be seen in two days.
5. Carrying out inhalations to children. To carry out this procedure, you will need a special inhaler. It requires a compression inhaler. Used for the nose. It is also used for the purpose of therapeutic treatment of mild forms of sinusitis. So parents will be able to achieve an expectorant and anti-edematous effect.

REFERENCE: the procedure of injections with antibacterial agents for this disease can become an allergy provocateur in children. In this regard, it is necessary to put droppers exclusively in stationary conditions in a medical clinic.

The main contraindication to the use of drugs is intolerance to patients of at least one of the components of antibiotics. If a child has a chronic form of diseases of the liver, kidneys and stomach, the pediatrician undertakes to adjust the dosage.

The doctor prescribes a broad-spectrum medication.

If there has never been sinusitis before, the patient is treated with antibiotics with the least amount of toxins. We are talking about penicillins from the category of macrolides:

1. Children from 6 years of age take Ampicillin in the form of tablets and injections, based on 100 mg per kilogram (daily dosage). It is necessary to take the drug 4-5 times a day. In general, the medicine is well tolerated, but if you use it for too long, a bacterial flora may develop. According to the reviews of people who have tried this method of treatment, a similar antibiotic Augmentin works much better. It is produced not only in the form of dragees, but also as a suspension.
2. You can take Klacid. It is prescribed for both adults (with the exception of pregnant women) and children. After reading the instructions for use, adults take pills of 250 and 500 mg - 1 piece. The dosage of children is calculated based on 15 mg per kilogram. It is divided into 2 doses, the interval between which is 12 hours. Side effects are extremely rare, however, heartburn, indigestion and bouts of nausea may begin.

If these drugs do not suit the patient, cephalosporins are prescribed instead. But there are cases when the disease proceeds in a rather stubborn course, which makes it necessary to prescribe more serious drugs. An extreme case can be called a drug called Cifran.

It should not be used by children under 5 years of age, as it is excessively toxic. It can lead to the development of complications of the nervous system, digestive tract, bones, as well as changes in the blood formula.

Based on this, its dose is prescribed individually, treated exclusively in a hospital.

In adults, the attending physician prescribes, depending on the form in which the disease proceeds.

Often, the empiric treatment for mild to moderate disease begins with Amoxicillin.

If after three days nothing improves, you should switch from this drug to clavulanic acid.

Alternatives include ceftriaxone and cefuroxime.

If improvements appear, the patient is prescribed cephalosporins for oral administration.

If sinus inflammation does not go well, they are changed to fluoroquinolones.

If there is a risk of an allergic reaction, as well as contraindications to the use of all of the above, macrolides are used.

Systemic antibiotics for sinusitis

Systemic antibacterial drugs are prescribed if therapeutic treatment is carried out in combination. Direct indications for their reception (list):

1. Acute progressive form of catarrhal sinusitis.
2. Much pus when the nose is very stuffed up.
3. Severe pain that is accompanied by migraines and discomfort in the maxillary sinuses.
4. Intoxication.
5. Prolonged unrelenting sinusitis.
6. Varieties of complications due to the disease.
7. A collection of symptoms.

Such medicines are perceived as bactericidal. Used to treat inflammation.

But there are bacteria that have a destructive effect on penicillins. Therefore, pharmacists have developed protected products with clavulanic acid.

In rare cases, there are consequences. They are associated with the fact that if you prescribe the wrong dosage, the gastrointestinal tract will begin to function poorly. There is also the possibility of allergies, etc.

Most often, these drugs are taken in tablets. But if you need to cure a small child, suspensions are quite suitable.

Penicillin medicines include:

• Flemoxin;
• Amoxicillin clavulanate;
• Hyconcil;
• Flemoklav;
• Amoxiclav;
• Augmentin.

Cephalosporins

Their chemical structure is similar to penicillin, but cephalosporins are more resistant to microorganisms.

The most effective are:

• Cefazolin;
• Cefuroxime;
• Ceftriaxone.

These medicines can be taken as injections, drink solution and swallow tablets. But if a person is prone to allergies, it is better for him to try using some other antibiotics.

If the patient has such a reaction to this category of drugs, penicillins should also be abandoned.

With the development of the bacterial form of the disease, it is necessary to use fluoroquinolones. These are effective destroyers of pathogens of sinusitis.

The most common are such medicines for sinusitis, such as:

• Ofloxacin;
• Levofloxacin and Levolet;
• Ciprofloxacin.

With a purulent form of the disease, fluoroquinolones are especially good. But only a doctor can prescribe them.

Treatment with macrolides

Treatment with macrolides affects the cessation of the development of pathogens of the acute form of the disease. Of all the categories of drugs, these are the most effective, since they can be safely prescribed to allergy sufferers.

The undeniable advantage of macrolides is that they can be used once a day. With a certain frequency, it is possible to carry out short-term treatment courses with antibacterial agents. The chronic form of the disease just needs such treatment.

Bright representatives of this category of medicines:

• Macrofoam;
• Clarithromycin for sinusitis;
• Sumamed;
• Fromilid;
• Erythromycin.

The release of these drugs is carried out in pills, powders and capsules.

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Injectable drugs

At the moment, the following drugs are considered in demand for injections in medical clinics:

• Biosynthetic penicillins;
• Cephalosporins;
• Aminoglycosides (for example, Gentamicin);
• Carbapenems.

Each person's body reacts differently to medications. For some, this option of therapeutic treatment is simply ideal, but for some it causes side reactions.

The most frequently encountered include:

• starts to feel sick;
• gagging;
• stool disorder;
• dizzy;
• development of allergies.

Often, contraindications to the necessary drug can be read in the instructions for use. Prohibitions on the use of antibiotics are not limited to problems with a diseased liver, heart and stomach. It is undesirable to start taking them for children who have not reached the age of 12 (with the exception of some categories of medicines).

The medicines used in the disease must be taken, being familiar with the circumstances under which they should not be used and under which they can be used. The most effective antibacterial drug is a remedy for sinusitis of a narrow focus, although it can not be used in all cases, since the causative agent of the inflammatory process is not always known.

Conclusion: do not neglect your health, it is better to sign up for a consultation with a specialist who will prescribe the optimal type of antibiotic for sinusitis, both for an adult and a child. You can buy medicines in pharmacies. But patients should not skimp on cheap anti-inflammatory drugs, as drug treatment will not be successful. The guarantee of the result will be provided by a specialized attending physician with experience.

In the last century, the use of a special group of drugs - antibiotics - was very popular. They began to be used to treat all ailments, infectious nature. A whole era of antibiotics has come - it was not difficult to purchase them at any pharmacy, so patients practically determined their own course of treatment. Consequently, improperly selected drugs caused a side effect in the form of an allergy, as well as resistance to the effects of an antibiotic.

The new time has given drugs that are based on plant materials and are able to quickly eliminate the inflammatory process. On the contrary, not all groups of antibiotics are able to withstand pathogenic viruses that provoke diseases such as herpes, some types of influenza, and the most common sinusitis. Therefore, it is advisable to figure out which antibiotics are effective for eliminating sinusitis and its consequences.

When the nasal sinuses become inflamed (the more accurate name is the maxillary sinuses), then such an unpleasant ailment as sinusitis occurs. Very often it acts as a complication of the simplest cold.

It is not at all difficult to determine the first symptoms in an adult. The first symptoms that should become the driving force behind an urgent trip to the doctor are characterized by:

1. When a person has a pressing and bursting feeling in the area of ​​​​the sinuses.
2. After that, mucous discharge may appear. In the absence of therapy, the inflammatory process intensifies and this can be understood by the green tint of the mucous secretions. In the event of the appearance of yellowish discharge, it is worth sounding the alarm, as this indicates the beginning of a purulent process.
3. Pain in the area of ​​the maxillary sinuses begins to disturb, which can intensify in the evening and radiates to the head. Also, the pain becomes much stronger when bending over.
4. The patient feels a breakdown, and the temperature rises significantly. But for chronic sinusitis (if the patient started the disease or chose the wrong therapy), then the temperature increase is not typical.

How is the diagnosis confirmed?

To determine the disease, radiography is used, it is thanks to it that the presence of purulent contents in the sinuses is determined. The most outdated method of treatment is a puncture. The procedure is not pleasant and scary for almost every adult. Fortunately, this technique has gone far into the past and is rarely used because of the dangerous consequences and extreme pain.

It is important! Remember that the doctor must send the patient to a smear, which determines the type of microorganism that provoked sinusitis. As a result, it is possible to choose an effective antibiotic as accurately as possible, which will quickly cope with the infection.

Antibiotics: when are they needed?

The first alarming symptoms are expressed in the form of copious purulent discharge, severe pain, which gives off to the head and fever. If sinusitis has not passed into the purulent stage, then you can get by with home treatment, which involves washing the nasal sinuses with a special solution, instillation with drops, herbal inhalations.

Before you start taking antibiotics, you should determine which pathogen caused the inflammatory process. As already mentioned, this can be done through a smear. You can not independently establish a diagnosis, and select antibiotics at random - this can lead to irreparable consequences. When the type of pathogens or virus is known, it is not difficult for a specialist to select the correct effective group of antibiotics.

Note! There are a number of cases when taking antibiotics will be completely useless. First of all, with allergic reactions. Against their background, sinusitis can easily begin to develop. Therefore, treatment with antibiotics will be inappropriate and ineffective. A similar result should be expected when a fungal infection has become a provocateur of sinusitis.

Without knowing the clinical picture of the course of the disease, one cannot ignore going to a specialist and confirming the diagnosis with subsequent diagnosis for the correct selection of medicines.

How are antibiotics taken correctly?

For successful treatment, a properly selected drug is not enough. After all, the result of recovery directly depends on the actions of the patient - how he follows the doctor's instructions, whether he interrupts antibiotics, whether he uses additional self-prescribed drugs that can block the action of the antibiotic.

So, a specialist, depending on the complexity of the course of the disease, prescribes an antibiotic in the form of injections, oral administration, or in the form of topical application. With moderate severity of sinusitis, they usually manage with tableted antibiotics. A more severe lesion requires mandatory intravenous administration, but it can also be intramuscularly. Upon relief, the patient will be transferred to oral medication.

When taking antibiotics, the patient must comply with the following recommendations:

1. Do not deviate from the dose prescribed by the doctor.
2. Take the drug strictly on time.
3. Do not interrupt the prescribed course of antibiotics unless side effects are observed.
4. Do not additionally take other drugs not agreed with the attending physician.
5. Never take alcohol and drugs at the same time.
6. When purchasing a drug, pay attention to the expiration date.
7. Additionally, to improve overall well-being, the doctor may prescribe fluids and anti-edema drugs. Do not ignore their reception.
8. Do not use self-selected nasal drops in parallel with antibiotics. The entire course of treatment is compiled by a doctor.

Reference! On average, the course of treatment with a tablet form lasts from one week to fourteen days. If this period is exceeded, the patient may experience intestinal dysbacteriosis. Consequently, beneficial microorganisms will be destroyed.

What antibiotics are used to eliminate sinusitis?

After establishing the diagnosis and subsequent determination of the pathogen, the specialist can choose an antibiotic from the main groups that are the most effective for eliminating sinusitis:

1. Penicillin. It is considered the most common antibiotic that is used for manifestations of sinusitis.
2. Macrolides. They are second only to penicillin. They are prescribed in case of individual intolerance to the penicillin group.
3. Fluoroquinolones. It is a synthetic antibiotic. It can quickly eliminate the activity of the pathogen - bacteria, since the latter have not yet developed immunity to it.
4. Cephalosporins. When there is no result from other drugs, then this type of antibiotic is prescribed, which perfectly eliminates any inflammatory process.

Attention! If the patient does not feel any relief already on the second or third day of taking the antibacterial drug, then this is evidence that the antibiotic is incorrectly selected and is not able to eliminate the pathogen. In addition, it is necessary to take into account the possible allergic consequences and the individual characteristics of the organism.

Video - Sinusitis: signs, symptoms and treatment

Treatment of sinusitis

Despite the fact that the symptoms of sinusitis provoked by pathogenic bacteria are similar to the symptoms of sinusitis caused by a virus infection, the treatment is still significantly different. Experts do not turn to antibiotics immediately, but only as a last resort, when the effect of local drugs is absent or abundant purulent discharge of a green or yellow tint from the sinuses has begun.

A special way is the treatment of viral sinusitis. After all, penicillin macrolides are not able to eliminate the virus. The patient will feel better with this type of sinusitis only when the virus passes into an inactive phase.

On the contrary, inflammation of a bacterial nature can be triggered by several types of pathogenic bacteria:

1. Enterobacteria.
2. Streptococci.
3. Staphylococci.
4. Moraxella.

When the patient does not have a purulent outflow from the nasal sinuses, there is no fever, but there is a strong edema, then allergic sinusitis is diagnosed. In this case, the effect of antibiotics is powerless.

Tablet form of antibiotics against sinusitis

Antibiotics can be found in the form of capsules and tablets - this is quite convenient and most preferred by patients, the form of release of the drug. There are several of the most effective antibiotics in tablet form, which do an excellent job with the disease and its consequences.

Name of the antibiotic	Image	Brief description of the action
macrofoam		A representative of one of the main groups of antibiotics - macrolides. The impact on pathogenic viruses occurs due to the active substance - midecamycin. Most often used for sinusitis, provoked by Haemophilus influenzae, as well as pneumococci. For adults, it is recommended to take the drug three times a day for two weeks.
Augmentin		Due to the complex composition, this drug has rightfully received the status of a third-generation antibiotic. The main effect is due to clavulanic acid. That's just the duration of treatment with this remedy should not exceed two weeks. Otherwise, there may be a manifestation of side effects: vomiting, and in the intestine - dysbacteriosis
Sumamed		A modern antibiotic from the group of macrolides, which is actively used in the treatment of sinusitis. Since the drug is potent, doctors prescribe it to take no more than five days. The frequency of intake is limited to once a day for half an hour before meals.
Flemoxin Solutab		This is a representative of a number of penicillin antibiotics. The main difference of the drug is resistance to the effects of gastric juice
Amoxiclav		An antibiotic of semi-synthetic penicillins, which is prescribed for many viral ailments - bronchitis, sinusitis. The main effect of the drug is the ability to destroy the walls of pathogenic bacteria. Please note that it is used exclusively for the treatment of sinusitis in adults.
Zitrolide		This is a drug of the macrolide group, which has a high antimicrobial effect. It is recommended to take once a day a couple of hours before meals. Please note that it is released strictly by prescription.

Attention! If the antibiotic did not show results in the form of an improvement in well-being within 48 hours, then it should not be taken longer, it is ineffective against sinusitis.

Intramuscular and intravenous types of antibiotics

When a patient has intoxication of the body, the use of injections is indicated, since antibiotics in this form are highly bioavailable. So, the following drugs are considered the most effective:

Name of the antibiotic	Image	Main action
Ceftriaxone		Since the drug is designated as a derivative of the penicillin group, it is customary to use it for most infectious diseases. This is a clear representative of third-generation antibiotics and the only salvation for exacerbation of purulent sinusitis. You can buy it in the form of a powder, from which an injection is prepared. It is allowed to enter both intravenously and intramuscularly. Please note that this antibiotic is prohibited for the treatment of pregnant women.
Cefazolin		Represents the cephalosporin group of semi-synthetic antibiotics. Upon administration of the drug, its concentration in the blood will last for twelve hours. Antibiotics should be used with caution as side effects such as stomach upset and, in some cases, allergies may occur.

Topical preparations

The early stages of sinusitis are not so difficult to eliminate with a special spray or drops. But, even in this form, antibiotics are produced.

Name of the antibiotic	Image	Essence of action
Isofra		One of the best alternatives to injections and pills. It is recommended to use at least four times a day for one week. Previously, before applying the spray, the nostrils are cleared of purulent mucus (possible by saline washing)
Polydex with phenylephrine		Antibiotic in the form of a spray, which has excellent vasoconstrictive and antibacterial effects. It is necessary to apply three times a day, and if necessary - five times. The duration of the course is one week. The active substances of the drug are polymyxin and neomycin

How to treat sinusitis in children with antibiotics?

Most often, children can suffer from complications after rhinitis, which manifest themselves in the form of sinusitis. At the same time, an allergic reaction is clearly manifested in children, so doctors prescribe anti-allergic drops without fail. In some cases, the use of antibiotics is not necessary.

Attention! When using a spray or drops, the child should not feel a burning sensation. If such discomfort is present, it is recommended to use sea water.

Name of the antibiotic	Image	Main action
Amoxicillin

Sinusitis is an inflammation of the paranasal sinuses, which can be caused by a number of reasons. Therefore, when characteristic symptoms appear (a runny nose with thick mucus that does not go away for a long time, headache, a feeling of fullness in the infraorbital region), it is necessary to visit a doctor, undergo a diagnosis and receive qualified recommendations. Ignoring the problem, symptomatic measures and self-treatment can result in the transition of sinusitis to a chronic form.

In the vast majority of cases, this disease is of a bacterial nature, therefore, antibiotics for sinusitis are first-line drugs. However, systemic antimicrobial therapy is prescribed only in cases where the patient's body cannot fight the infection on its own for a long time and there is a risk of severe complications. Bacteria from the maxillary sinuses can enter the lower respiratory tract through the bloodstream and cause or even pneumonia. But the main danger is the proximity of the focus of inflammation to the brain and the possibility of developing or.

To understand in which cases the use of antibiotics for sinusitis is really necessary, you need to consider the causes of the development of this disease.

According to the etiology, sinusitis is divided into the following categories (in descending order of occurrence):

Bacterial - caused by pneumonia, pyogenic or viridescent streptococcus, Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa or Escherichia coli, Moraxella, Klebsiella, Chlamydia, Mycoplasma, Proteus and other pathogenic and conditionally pathogenic microorganisms. It occurs as a result of the pathogen entering the maxillary sinuses from the upper respiratory tract (rhinitis, pharyngitis), the dental system (, flux, root granuloma, periodontitis) or the general blood flow in inflammatory diseases (scarlet fever, measles). It happens both unilateral and bilateral, more often purulent than catarrhal (only edema);

Viral - caused by rhinoviruses, coronaviruses, adenoviruses, enteroviruses, influenza A and B, parainfluenza. It usually occurs against the background of seasonal, it is always bilateral, most often catarrhal, sometimes asymptomatic and goes away on its own in 1-2 weeks. With viral sinusitis, antibiotics are useless, or rather, harmful. But on the 7-10th day, severe, acute respiratory viral infections or acute respiratory infections can be complicated by a bacterial infection with accumulation of pus in the maxillary sinuses, then antimicrobial therapy is indicated;

Mixed - caused by a complex of reasons, among which there may be viruses, bacteria, fungi and allergens. Often goes from acute to chronic. It is almost always bilateral and is combined with other forms of sinusitis (frontal sinusitis, ethmoiditis and sphenoiditis). It can have any character: purulent, catarrhal, serous, exudative. With mixed viral-bacterial sinusitis, antibiotics are used, however, the selection of the drug must be carried out very carefully based on the results of the tests and the data of the medical history;

Allergic - caused by a negative reaction of the body to allergens, among which inhaled particles predominate (household dust, poplar fluff, plant pollen). It is always bilateral, characterized by severe swelling of the mucous membranes, sneezing and rhinorrhea. Antibiotics for sinusitis of an allergic nature are not needed, measures are prescribed and taken to eliminate the allergen from the patient's everyday life;

Fungal - caused by yeast-like microorganisms and fungi against the background of immunodeficiency states in debilitated patients, the elderly, young children. It is very rare, it is bilateral, it is characterized by a persistent, chronic course, it requires an integrated approach to treatment. With fungal sinusitis, antibiotics are categorically contraindicated;

medical- is caused by prolonged use of drugs that have a detrimental effect on the mucous membranes of the maxillary sinuses and disrupt the normal functioning of the ciliated epithelium, which is responsible for the evacuation of mucus. It usually occurs against the background of the abuse of vasoconstrictor drops in the nose. It is almost always bilateral, it can be atrophic (tissue necrosis), hyperplastic (mucosal proliferation) or cystic-polyposis (the appearance of polyps that overlap the mouth of the maxillary sinuses) in nature. Without the addition of a bacterial infection, such sinusitis is not treated with antibiotics;

Traumatic - caused by mechanical damage to the maxillary sinuses, the accumulation of blood and exudate in them and subsequent inflammation. In this case, the patient is shown antibiotics, physiotherapy, and sometimes surgical treatment.

In order to select the optimal antibacterial drug for the treatment of sinusitis, the doctor takes into account the following patient data:

Medical history - when and under what circumstances the disease occurred (seasonal cold, systemic infection, hay fever, trauma), what is the nature of the symptoms (body temperature, degree of intoxication of the body, severity of pain syndrome, color and consistency of nasal mucus), how long ago the person fell ill, tried whether something to be treated independently;

The results of the examination and analyzes- X-ray, complete blood count, bacterial culture;

Age and status- many antibiotics for sinusitis are not used in children, debilitated and elderly people, pregnant and lactating women;

Information about previously used antibiotics- the more often a person is treated with the same antibacterial drug, the less effective it becomes;

The presence of allergies.

Based on this, it can be understood that the most effective antibiotic for sinusitis will be the drug to which the pathogen is sensitive, there is no resistance, allergies and contraindications, side effects and harm to the body are minimal. Since most modern antibiotics have a very broad spectrum of action and are active against almost all microbes that cause sinusitis, the need for bacterial culture and the establishment of a specific culprit of the disease arises only when the course of therapy has not yielded results.

The most commonly used and effective antibiotics for sinusitis fall into four groups:

These are synthetic penicillins in combination with special substances that neutralize bacterial resistance. Over the years of active use of penicillins and cephalosporins, many pathogens have adapted to them and developed an enzyme from the beta-lactamase group, called "penicillinase", which simply destroys the drug that enters the body and prevents it from fighting the infection. To avoid this, sulbactam or clavulanic acid is added to penicillins.

Most effective against sinusitis:

Ampicillin sulbactamates (Ampisid, Libakcil, Unazin, Sultasin, Sulbacin, Sulacillin, Sultamicillin);

Amoxicillin clavulanates (Amoxiclav, Ekoklav, Rapiclav, Flemoklav, Panklav, Augmentin).

The usual amoxicillin, which is sold for a lot of money under the brand name Flemoxin Solutab, in most cases does not help with sinusitis.

Protected penicillins have a bactericidal effect (destroy bacteria), moreover, they do it targetedly, since they are guided by special markers of the cell membranes of pathogens. There are no similar cells in the human body, so this therapy does not destroy healthy tissues. Penicillins are widely used to treat sinusitis in children. However, this group of drugs often occurs, and long-term use is fraught with an imbalance in the microflora of internal organs, side effects from the gastrointestinal tract, and the development of fungal infections. Another minus of penicillins is the short half-life, which is why the pills have to be taken every 4-6 hours.

These drugs are very convenient to use, because they accumulate well in tissues and remain in them for a long time. Macrolides of the latest generations are sold in packages containing only a few capsules. Uncomplicated infections are successfully treated even with a single dose. If the patient has an individual intolerance to penicillins, an atypical or mixed form of the disease, macrolides will be the most effective antibiotics for sinusitis.

The disadvantages include the high cost of some drugs in this group. Use in childhood, during pregnancy and lactation is possible when the potential risk is lower than the expected benefit.

Macrolides are divided into:

14-membered - Erythromycin, Roxithromycin (Rulid, Xitrocin, Elrox, Roxilor, Rovenal), Clarithromycin (Klacid, Klabaks, Claricin, Ecocitrin, Fromilid Uno);

15-membered Azithromycin and its analogues, called azalides (Hemomycin, Sumamed, Azitral, Azitrox, Azitrus, Zitrolid, Zi-factor);

16-membered - Midecamycin (Macropen, Midepin), Spiramycin (Rovamycin, Spiramisar), Josamycin (Vilprafen).

This is one of the most numerous and long-used groups of antibiotics. They have a bactericidal effect. To date, there are already five generations of cephalosporins. In terms of the breadth of the antibacterial spectrum, they do not exceed penicillins and, moreover, macrolides, however, they are resistant to beta-lactamases - enzymes that explain the resistance of some pathogens of sinusitis. However, this statement is true for far from all cephalosporins.

If a patient is allergic to penicillins, then with a high probability he will have a negative reaction to cephalosporins. Side effects are also similar, treatment of sinusitis in children is possible during pregnancy and the issue is resolved individually. Many drugs in this group are unsuitable for oral administration, because they are not absorbed from the gastrointestinal tract, and even strongly irritate the mucous membranes. The advantages of cephalosporins as antibiotics for sinusitis include an affordable price.

This is important: cephalosporins are absolutely incompatible with alcohol, since they inhibit the synthesis of the aldehyde dehydrogenase enzyme by the liver, which is necessary to neutralize the toxic effects of ethanol breakdown products on the body.

Cephalosporins are divided into:

1st generation - Cefazolin (Lizolin, Kefzol, Zolfin), Cefalexin (Ecocephron, Sporidex, Lexin);

2nd generation - Cefuroxime (Zinacef, Cefurus, Aksetin), Cefoxitin (Anaerocef, Boncefin, Mefoxin);

3rd generation - Cefixime (Supraks, Maksibat, Lopraks), Ceftriaxone (Rocefin, Azaran, Lendacin);

4th generation - Cefpir (Isodepem, Cefanorm), Cefepim (Cefomax, Maximim);

5th generation - Ceftobiprol (Zaftera), Ceftolosan.

The drugs of this group are very different from other antibiotics from sinusitis, because they are completely synthetic and do not occur in wildlife. Fluoroquinolones have a wide range of antibacterial effects, have a very rapid and pronounced bactericidal effect on most pathogens of sinusitis, including its atypical forms caused by chlamydia or mycoplasmas. However, due to their high toxicity and alien, artificial origin, they often lead to the development of allergies and the occurrence of severe side effects from the gastrointestinal tract and nervous system.

As antibiotics for sinusitis in children, fluoroquinolones are considered only in extreme cases; they are categorically contraindicated for pregnant and lactating women. Another disadvantage of drugs in this group is the high price, but if you look for a medicine by the active substance, and not by a well-known brand, you can save a lot.

Fluoroquinolones are divided into:

1st generation - Ofloxacin (Tarivid, Zanotsin), Pefloxacin (Abaktal, Yunikpev);

2nd generation - Ciprofloxacin (Tsiprolet, Tsifran, Tsifrinol, Tsiprobay, Ecocifol), Norfloxacin (Nolitsin, Normaks, Norbaktin);

3rd generation - Levofloxacin (Glevo, Tavanik, Levostar), Sparfloxacin (Sparflo, Respara, Sparbakt);

4th generation - Moxifloxacin (Moxin, Avelox, Megaflox), Gemifloxacin (Faktiv).

Pros and cons of antibiotics for sinusitis

The best antibiotic for sinusitis can be selected by analyzing a swab from the nose. 48 hours after taking the prescribed antibiotic, there must be a positive reaction, otherwise an urgent replacement will be required. Perhaps the pathogen has managed to develop resistance to this antibiotic, or the nature of sinusitis is not bacterial - it is viral, fungal, allergic or mixed.

Ceftriaxone for sinusitis

Along with many other cephalosporin-type antibiotics, ceftriaxone is considered an effective drug for the treatment of sinusitis. It belongs to the third generation and has a powerful bactericidal effect against the vast majority of microbes that cause sinusitis. Ceftriaxone is very often prescribed for inflammatory diseases of the nasopharynx, throat, bronchi and lungs. Its effectiveness is so high that it is even used to treat sepsis, peritonitis and meningitis.

pros

The main advantage of Ceftriaxone is the high effectiveness of the treatment of bacterial infections, the development of which needs to be urgently stopped. Since this antibiotic has a strong and rapid bactericidal effect, it is very well suited for the treatment of acute sinusitis, accompanied by severe pain, fever, a large accumulation of pus in the sinuses and severe intoxication of the body. In such a situation, it is bactericidal and non-bacteriostatic antimicrobials for sinusitis that are most effective and help you get back on your feet faster.

The second undoubted plus of Ceftriaxone is that it is a modern drug resistant to beta-lactamase, which means that the likelihood that the causative agent of sinusitis will be resistant to it is close to zero. The third advantage of Ceftriaxone is its affordable price: you can buy a package of powder in ampoules for the preparation of an injection solution of domestic production for 25-50 rubles. Foreign analogues (Rocefin, Azaran, Lendatsin) cost from 500 to 2500 rubles.

Minuses

The main disadvantage of Ceftriaxone is associated with a high risk of side effects. Treatment of sinusitis with this drug is sometimes accompanied by gastrointestinal disorders, jaundice and interstitial. Therefore, antibiotics from the cephalosporin group are not the first choice in the case of sinusitis. Ceftriaxone is prescribed to pregnant women only if other therapies have failed and there is a threat to life. During breastfeeding, the drug is contraindicated. For the treatment of sinusitis in young children, the dosage is selected individually.

The second obvious minus of Ceftriaxone is the impossibility of oral administration, since this antibiotic, like many other cephalosporin drugs, is practically not absorbed from the gastrointestinal tract and has a strong irritating effect on the mucous membranes. Ceftriaxone is administered intravenously or intramuscularly 1-2 times a day and in no case is mixed with calcium solutions. As we mentioned above, cephalosporins are also completely incompatible with ethanol.

The third disadvantage of Ceftriaxone as an antibiotic for sinusitis is the numerous undesirable interactions with other drugs. When combined with drugs that reduce platelet aggregation (for example, with conventional Aspirin), there is a risk of developing internal bleeding. And when taken simultaneously with loop diuretics, the nephrotoxic effect of Ceftriaxone is aggravated. Mixing this drug with antibiotics of other groups to enhance the effect is unacceptable.

Augmentin (amoxiclav) from sinusitis

The drug Augmentin (aka amoxiclav) is a broad-spectrum antibiotic that has a powerful bactericidal effect on most pathogens of sinusitis. It belongs to the category of protected semi-synthetic aminopenicillins, which contain clavulanic acid, a special substance that destroys beta-lactamase enzymes, with which bacteria try to destroy antibiotics from sinusitis, although it should be the other way around. A popular analogue of Augmentin is the drug Amoxiclav: they have an absolutely identical composition, but a slightly different price - the second option is cheaper.

pros

Augmentin is a modern antibacterial drug developed by the specialists of the British pharmaceutical company SmithKline Beecham Pharmaceuticals, which has a very high reputation in the market, is famous for the high quality and safety of its products. It is the protected semi-synthetic aminopenicillins, such as Augmentin and Amoxiclav, that are today considered the most effective antibiotics for sinusitis, since they are not afraid of the acquired resistance of pathogens.

The second undoubted plus of Augmentin is that this antibiotic has a selective bactericidal effect, recognizing pathogenic microbes by special markers on their cell membranes. And since there are no similar cells in the human body, during the treatment of sinusitis with Augmentin, healthy tissues will not be damaged. That is why protected semi-synthetic aminopenicillins of the latest generation are most often used in the treatment of ENT diseases in children.

The third indisputable advantage of Augmentin is its ease of use - to maintain the therapeutic effect, it is enough to take the drug 2 times a day. In some special cases, a single daily dose or division of the dosage into 3-4 doses is indicated.

Minuses

All the disadvantages of Augmentin, like other penicillin antibiotics used to treat sinusitis, are centered around side effects. Patients often experience nausea and. Cases of damage to the liver and kidneys are known. Sometimes local allergic reactions develop, candidiasis, as well. Among the disadvantages of Augmentin, it is difficult not to attribute its high cost.

Sumamed from sinusitis

Sumamed belongs to the second generation of macrolides, consisting of 15-membered azalides - Azithromycin and its analogues. However, it is Sumamed that is the most popular drug in this group, since it is produced by reputable pharmaceutical companies (Teva - Israel and PLIVA HRVATSKA - Croatia), is of high quality and has been successfully used to treat complex bacterial infections, including sinusitis, for many years.

pros

The main advantage of Sumamed is the widest possible antibacterial spectrum. This antibiotic is effective even with atypical sinusitis caused by obligate microorganisms - mycoplasma and chlamydia. If we are talking about a mixed, multifactorial infection with a chronic course, it is Sumamed with its bacteriostatic effect that can stop sinusitis and prevent remission. This drug deprives the bacteria of the opportunity to multiply, which means that no matter how many of them are in the body at the time of the start of therapy, the disease will inevitably stop, because the existing pathogens will gradually destroy the cells of the immune system, and new colonies will not be able to appear.

The second huge plus of Sumamed is a record short course of treatment of sinusitis (5-7 days) and ease of administration (1 capsule per day). This drug accumulates very well in the tissues and stays there for a long time, so there is no need to take pills every 4-6 hours, as is the case with many other popular antibiotics for sinusitis.

The third advantage of Sumamed is the relatively low risk of side effects. Only about 10% of patients undergoing treatment of sinusitis with this drug report malfunctions in the gastrointestinal tract (nausea, heartburn, dry mouth, epigastric discomfort, diarrhea) or troubles from the nervous system (headache, fatigue, insomnia). Allergic reactions and serious pathologies of internal organs develop during Sumamed therapy extremely rarely.

Minuses

The main disadvantage of Sumamed from sinusitis is the restrictions on the age, status and health of the patient. This antibiotic is contraindicated in pregnant and lactating women, children under 12 years of age (we are talking about oral capsules, powder is available for babies), as well as people with severe kidney and liver failure and a number of other serious diseases.

The disadvantages of such an effective antibiotic for sinusitis as Sumamed can only be attributed to a high price, but this problem can be easily solved by selecting an affordable analogue. If the original Sumamed costs 400-500 rubles, then domestic Azithromycin will cost you from 80 to 120 rubles, and it will cure chronic sinusitis just as effectively.

Macropen from sinusitis

Macropen belongs to the last, third generation of macrolides. The active substance of this drug is called midecamycin. Compared to its predecessor, azithromycin, this antibiotic is even less toxic to the human body and has an even more pronounced bacteriostatic effect against the vast majority of pathogens of sinusitis, including atypical, chronic and mixed forms of the disease.

pros

Continuing to compare Macropen and Sumamed in terms of their effectiveness in the treatment of sinusitis, we note a higher rate of absorption and onset of a therapeutic effect in Macropen - an hour after taking the drug, the required concentration of the substance is established in the patient's blood. However, the half-life of midecamycin is shorter than that of azithromycin, therefore, a more modern antibiotic will have to be taken more often - 1 capsule of 400 mg 3 times a day (for adults and children weighing more than 30 kg).

The second most important advantage of Macropen, not only over other macrolides, but also over any antibiotics for sinusitis, is the minimal risk of unwanted side effects. In very rare cases, patients complain of nausea, diarrhea, hives or headache. The incidence of complications even with prolonged use of Macropen does not exceed 4%.

Minuses

The disadvantages of Macropen include restrictions on the status and state of health of patients: it is not prescribed to people with severe forms of renal and hepatic insufficiency and with a number of other serious pathologies. However, absolutely all antibiotics for sinusitis have the same contraindications for use, so the question of the appropriateness of therapy should be decided individually. The same applies to the treatment of sinusitis in pregnant women - the risk must be justified.

The second minus of Macropen is a rather high cost (250-400 rubles), moreover, it is unlikely that it will be possible to choose a more affordable analogue. Midecamycin is one of the most modern antibiotics, so the pharmacological industry has not yet managed to release many drugs based on it, as in the case of its predecessor, azithromycin.

Flemoxin Solutab from sinusitis

Flemoxin Solutab is the most popular brand today, under which the well-known antibiotic of the penicillin series amoxicillin in the form of trihydrate has been produced for a long time. It is active against bacteria that most often cause acute sinusitis (pneumonic streptococcus, Staphylococcus aureus, Pseudomonas aeruginosa, Moraxella, Klebsiella, etc.) and has a rapid and pronounced bactericidal effect on them.

pros

The main advantage of Flemoxin lies in its selectivity - only the cells of the pathogens are destroyed, and the tissues of the human body do not suffer from the toxic effect of the drug. For this reason, amoxicillin is the first line antibiotic in the treatment of sinusitis, including in young children.

The popularity of the Flemoxin Solutab tablets themselves, compared with other brands of amoxicillin, is explained by two reasons: firstly, the trihydrate is absorbed faster and easier by the gastrointestinal tract, without causing irritation of the mucous membranes. And secondly, Flemoxin Solutab is a convenient, easily broken into two halves chewable tablets with a pleasant tangerine-lemon taste.

Minuses

We already talked about the contraindications and side effects of amoxicillin when we considered Augmentin and Amoxiclav - in this respect, the drugs are identical. However, it is in their differences that the main minus of Flemoxin lies. The fact is that it is an unprotected antibiotic and is destroyed by penicillinase, an enzyme with which many bacteria successfully “defend themselves” from antimicrobial therapy. Resistance of causative agents of acute sinusitis to the drug Flemoxin Solutab has become common in recent years, especially in pediatric practice.

But even if sinusitis is successfully treated with unprotected amoxicillin, you will have to take tablets 3-4 times a day for 7-14 days due to the short half-life of the active substance from the body. Given the high cost of the drug Flemoxin Solutab (up to 600 rubles, depending on the dosage), a full course of therapy will cost a tidy sum.

Isofra with sinusitis

Isofra is a topical antibacterial drug for sinusitis in the form of a nasal spray. The active component of Isofra is the antibiotic framycetin, which belongs to the group of aminoglycosides and has a bactericidal effect on some pathogens of sinusitis (staphylococcus, Escherichia and Pseudomonas aeruginosa, Klebsiella, Enterobacterium, Proteus). Framycetin is not used orally, since it is very toxic to the human body, however, irrigation of the nasopharynx with Isofra spray is accompanied by scanty absorption of the drug into the blood, so this treatment of sinusitis is effective and safe.

pros

The main advantage of Isofra nasal spray over other antibiotics for sinusitis is the almost complete absence of contraindications for use and side effects, because the active substance does not penetrate the gastrointestinal tract (and therefore cannot cause nausea or diarrhea, or linger in the body due to kidney or liver dysfunction ) and does not accumulate in the blood (and therefore cannot cause allergies or problems from the nervous system).

The undoubted advantages of Isofra from sinusitis include ease of use: one light press allows you to get the exact dose of the drug (for adults 4-6 times a day, one injection in each nostril, and for children - 3 times). Isofra has a subtle lemon aroma, so the treatment of sinusitis and runny nose does not cause dissatisfaction in the smallest patients. The drug is produced in France by the pharmaceutical company Laboratoires BOUCHARA-RECORDATI, which is also known for its effective antiviral drug Polydex.

Minuses

A significant minus of Isofra is the narrowness of the antibacterial spectrum. The fact is that framycetin does not have a bactericidal effect on streptococcus pneumoniae, and this is one of the most commonly diagnosed pathogens of acute sinusitis. Resistant to it and anaerobic microorganisms (Peptostreptococci, bacterioids, fusobacteria), which also sometimes cause sinusitis, especially its chronic and constantly recurring forms. Therefore, it is advisable to conduct a short 7-10-day course of treatment of sinusitis with Isofra, and if it does not work, move on to another drug.

The disadvantages of the Isofra spray include a rather high price (250-400 rubles), but this is the only effective local antibiotic for sinusitis, so it is worth the money. The only contraindication to its use is damage to the partitions and the period after the puncture of the maxillary sinuses, since in this case the active substance will penetrate into the blood in an unacceptably large volume.

Dioxidine for sinusitis

Dioxidine (hydroxymethylquinoxaline dioxide) is a very broad-spectrum bactericidal antibiotic, a derivative of quinoxaline. It is active against all strains of streptococcus and staphylococcus, Pseudomonas aeruginosa and Escherichia coli, shigella, salmonella, and pathogenic anaerobes. Causative agents of sinusitis that are resistant to other antibiotics usually do not withstand the onslaught of dioxidine, so the drug has long been successfully used to treat rhinitis and sinusitis. The optimal form is a 0.5% solution in ampoules, which should be instilled into the nose.

pros

The main advantage of Dioxidin, as a local antiseptic for sinusitis, is the breadth of the antibacterial spectrum and rapid sanitation of the nasopharynx. By instilling 5 drops of the solution into each previously cleaned nostril 4-6 times a day, in a week you can count on a radical improvement in well-being in the acute form of the disease.

The second plus of this drug is its relatively affordable price - one ampoule will cost you about 50 rubles. However, keep in mind that after opening it can not be stored in the refrigerator for more than one day. Therefore, for a full course of treatment of sinusitis with this antiseptic, most likely, the entire package of 10 ampoules will go.

Minuses

Dioxidine is extremely toxic, and it is absorbed into the blood through the mucous membranes when the solution is administered intranasally in volumes sufficient to develop side effects. Therefore, the official instructions for the drug states that it is contraindicated in pregnant and lactating women, as well as children under 18 years of age. But, despite this, many practicing ENT doctors prescribe this antibiotic for the treatment of sinusitis, even for babies 3-4 years old. How to accept such recommendations is the personal choice of parents.

The second disadvantage of Dioxidin is that by itself it does not cure sinusitis completely, therefore it is always prescribed as part of complex antibacterial therapy. That is, you will not only have to bury a potentially dangerous (and, by the way, terribly bitter) liquid in your nose, but also take antibiotics orally or by injection. It is obvious that such an approach to the treatment of sinusitis is justified only in the case of a severe, complicated course of the disease and a real threat to health.

Education: In 2009 he received a diploma in the specialty "Medicine" at Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in the specialty "Otorhinolaryngology" (2010)