Antibiotics For Sinusitis: Pros And Cons, A List Of Drugs

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Antibiotics for sinusitis: pros and cons

Sinusitis is an inflammation of the paranasal sinuses that can be caused by a variety of reasons. Therefore, with the appearance of characteristic symptoms (a long-term runny nose with thick mucus, headache, a feeling of fullness in the infraorbital region), it is necessary to visit a doctor, undergo diagnostics and receive qualified recommendations. Ignoring the problem, symptomatic measures and self-medication can turn into a chronic sinusitis.

In the overwhelming majority of cases, this disease is bacterial in nature, therefore, antibiotics for sinusitis are drugs of the first stage. However, systemic antimicrobial therapy is prescribed only in cases where the patient's body cannot independently overcome the infection for a long time and there is a risk of severe complications. Bacteria from the maxillary sinuses with the blood flow can enter the lower respiratory tract and cause bronchitis or even pneumonia. But the main danger is the proximity of the focus of inflammation to the brain and the possibility of developing meningitis or encephalitis.

The content of the article:

• When are antibiotics needed for sinusitis?

• What antibiotics are most effective for sinusitis

  • Protected aminopenicillins;
  • Macrolides;
  • Cephalosporins;
  • Fluoroquinolones
• Pros and cons of antibiotics for sinusitis

When are antibiotics needed for sinusitis?

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

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

• Bacterial - caused by pneumonia, pyogenic or green streptococcus, Staphylococcus aureus, hemophilus influenzae, Pseudomonas aeruginosa or Escherichia coli, moraxella, Klebsiella, chlamydia, mycoplasma, Proteus and other pathogenic and opportunistic microorganisms. It occurs as a result of the entry of the pathogen into the maxillary sinuses from the upper respiratory tract (rhinitis, tonsillitis, pharyngitis), the dentition (caries, flux, root granuloma, periodontitis) or 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 a seasonal cold, is always bilateral, most often catarrhal, sometimes asymptomatic, and resolves itself in 1-2 weeks. With viral sinusitis, antibiotics are useless, or rather, harmful. But on days 7-10, severe flu, ARVI 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, which may include viruses, bacteria, fungi and allergens. It often goes from acute to chronic form. It is almost always bilateral and combined with other forms of sinusitis (frontal sinusitis, ethmoiditis, and sphenoiditis). It can be of any character: purulent, catarrhal, serous, exudative. With mixed viral-bacterial sinusitis, antibiotics are used, however, the selection of the drug should be carried out very carefully based on the results of analyzes and data from the medical history;
• Allergic - caused by a negative reaction of the body to allergens, among which inhaled particles prevail (household dust, poplar fluff, 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, antihistamines are prescribed and measures are 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, sometimes bilateral, is characterized by a persistent, chronic course, requires an integrated approach to treatment. With fungal sinusitis, antibiotics are categorically contraindicated;

• Medication - 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 abuse of vasoconstrictor nasal drops. It is almost always bilateral, can be atrophic (tissue necrosis), hyperplastic (proliferation of the mucous membrane) 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 cannot be 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.

What antibiotics are effective for sinusitis?

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, the severity of the pain syndrome, the color and consistency of nasal mucus), how long has the person been sick, tried whether to be treated with something on their own;
• Examination and test results - X-ray, complete blood count, bacterial culture;
• Age and status - many antibiotics for sinusitis are not used in children, weakened 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 he 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 inoculation and the identification of a specific culprit of the disease arises only when the course of therapy that has been completed has not yielded results.

The most commonly used and effective antibiotics for sinusitis belong to four groups:

Protected aminopenicillins

These are synthetic penicillins in combination with special substances that neutralize bacterial resistance. Over the long 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 infection. To avoid this, sulbactam or clavulanic acid is added to penicillins.

The most effective against sinusitis are:

• Sulbactamates of ampicillin (Ampisid, Libakcil, Unazin, Sultasin, Sulbacin, Sulacillin, Sultamicillin);
• Amoxicillin clavulonates (Amoxiclav, Ekoklav, Rapiklav, 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 this in a targeted manner, since they are guided by special markers of the cell walls 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, allergies often occur to drugs in this group, and prolonged use is fraught with imbalance in the microflora of internal organs, side effects from the gastrointestinal tract, and the development of fungal infections. Another disadvantage of penicillins is the short half-life, which is why the tablets have to be taken every 4-6 hours.

Macrolides

Antibiotics of this group are the safest for humans, and are least likely to cause allergies and side effects. Unlike penicillins, they have a bacteriostatic effect (prevent bacteria from multiplying), which is very beneficial for persistent, chronic sinusitis. In addition, macrolides are effective against obligate intracellular parasites (mycoplasma, chlamydia), which recently also often cause sinusitis.

These drugs are very convenient to use, since they accumulate well in tissues and remain in them for a long time. The latest generation of macrolides are sold in packs containing just a few capsules. Uncomplicated infections can be 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. Application 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, Roxylor, Rovenal), Clarithromycin (Klacid, Klabax, Claricin, Ecositrin, Fromilid Uno);
• 15-membered Azithromycin and its analogs called azalides (Hemomycin, Sumamed, Azitral, Azitrox, Azitrus, Zitrolide, Z-factor);
• 16-membered - Midecamycin (Macropen, Midepin), Spiramycin (Rovamycin, Spiramisar), Josamycin (Vilprafen).

Cephalosporins

This is one of the most numerous and long-used groups of antibiotics. They have a bactericidal effect. Today, there are already five generations of cephalosporins. In terms of the width of the antibacterial spectrum, they do not surpass penicillins and, moreover, macrolides, but they are resistant to beta-lactamases - enzymes that explain the resistance of some causative agents of sinusitis. However, this statement is true for not all cephalosporins.

If a patient is allergic to penicillins, it is highly likely that he will have a negative reaction to cephalosporins. Side effects are also similar, treatment of sinusitis in children is possible, during pregnancy and lactation, the issue is decided individually. Many drugs in this group are unsuitable for oral administration, since they are not absorbed from the gastrointestinal tract, and even strongly irritate the mucous membranes. The pluses of cephalosporins as antibiotics for sinusitis include an affordable price.

This is important: cephalosporins are absolutely incompatible with alcohol, since they inhibit the liver synthesis of the enzyme aldehyde dehydrogenase, 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), Cephalexin (Ecocephron, Sporidex, Lexin);
• 2nd generation - Cefuroxime (Zinacef, Cefurus, Axetin), Cefoxitin (Anaerocef, Boncefin, Mefoxin);
• 3rd generation - Cefixim (Suprax, Maksibat, Loprax), Ceftriaxone (Rocefin, Azaran, Lendacin);
• 4th generation - Cefpir (Izodep, Tsefanorm), Tsefepim (Tsefomax, Maxipim);
• 5th generation - Ceftobiprol (Zaftera), Ceftolosan.

Fluoroquinolones

Drugs in this group are very different from other antibiotics for sinusitis, since they are completely synthetic and do not occur in nature. Fluoroquinolones have the widest spectrum of antibacterial action, have a very rapid and pronounced bactericidal effect on most causative agents of sinusitis, including its atypical forms caused by chlamydia or mycoplasma. However, due to their high toxicity and foreign, artificial origin, they often lead to the development of allergies and the occurrence of severe side effects from the gastrointestinal tract and the 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, however, if you look for a drug by the active ingredient, and not by a well-known brand, you can save a lot.

Fluoroquinolones are divided into:

• 1st generation - Ofloxacin (Tarivid, Zanocin), Pefloxacin (Abaktal, Unicpev);
• 2nd generation - Ciprofloxacin (Ciprolet, Cifran, Cifrinol, Tsiprobay, Ecocifol), Norfloxacin (Nolitsin, Normaks, Norbactin);
• 3rd generation - Levofloxacin (Glevo, Tavanik, Levostar), Sparfloxacin (Sparflo, Respara, Sparbact);
• 4th generation - Moxifloxacin (Moxin, Avelox, Megaflox), Hemifloxacin (Faktiv).

List:

• Ceftriaxone
• Augmentin
• Sumamed
• Macropen
• Flemoxin Solutab
• Isofra
• Dioxidine

Pros and cons of antibiotics for sinusitis

The best antibiotic for sinusitis can be selected by analyzing a swab from the nose. There must be a positive reaction 48 hours after taking the prescribed antibiotic, otherwise an urgent replacement will be required. Perhaps, the pathogen has managed to form 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 efficiency of the treatment of bacterial infections, the development of which must 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, large accumulation of pus in the sinuses and severe intoxication of the body. In such a situation, it is bactericidal and non-bacteriostatic antimicrobial drugs 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-lactamases, which means that the probability 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 preparing an injectable solution of domestic production for 25-50 rubles. Foreign analogues (Rocefin, Azaran, Lendacin) cost from 500 to 2500 rubles.

Minuses

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

The second obvious disadvantage of Ceftriaxone is the impossibility of oral administration, since this antibiotic, like many other drugs of the cephalosporin series, 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 it mixed with calcium solutions. As we mentioned above, cephalosporins are completely incompatible with ethanol.

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

Augmentin (amoxiclav) from sinusitis

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

pros

Augmentin is a modern antibacterial drug developed by specialists from the British pharmaceutical company SmithKline Beecham Pharmaceuticals, which has a very high reputation in the market and is famous for its 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 the human body lacks at least some similar cells, in the process of treating sinusitis with Augmentin, healthy tissues will not be damaged. That is why the latest generation of protected semi-synthetic aminopenicillins are most often used in the treatment of diseases of the ENT organs 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 dividing 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 heartburn. Cases of liver and kidney damage are known. Sometimes local allergic reactions, candidiasis, and intestinal dysbiosis develop. It is difficult not to include its high cost among the disadvantages of Augmentin.

Sumamed for sinusitis

Sumamed belongs to the second generation of macrolides, consisting of 15-membered azalides - Azithromycin and its analogues. However, Sumamed 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 for 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 will be able to stop sinusitis and prevent remission. This drug deprives bacteria of the ability to multiply, which means, 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 the record-breaking short course of sinusitis treatment (5-7 days) and ease of use (1 capsule per day). This drug accumulates very well in 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 for sinusitis with this drug notice disruptions in the gastrointestinal tract (nausea, vomiting, heartburn, dry mouth, epigastric discomfort, flatulence, diarrhea) or troubles from the nervous system (headache, rapid fatigue, insomnia). Allergic reactions and serious pathologies of internal organs develop extremely rarely against the background of Sumamed therapy.

Minuses

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

The disadvantages of such an effective antibiotic for sinusitis, like Sumamed, can only be attributed to the 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 80 to 120 rubles, and chronic sinusitis will cure just as effectively.

Macropen for sinusitis

Macropen belongs to the last, third generation of macrolides. The active ingredient in this drug is called midecamycin. Compared with 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 causative agents of sinusitis, including atypical, chronic and mixed forms of the disease.

pros

Continuing to compare Macropen and Sumamed in terms of their effectiveness in treating sinusitis, we note a higher absorption rate and the onset of a therapeutic effect in Macropen - within 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 azithromycin, therefore, a more modern antibiotic will have to be taken more often - 3 times a day, 1 capsule 400 mg (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 for people with severe forms of renal and hepatic failure 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 disadvantage of Macropen is a rather high cost (250-400 rubles), moreover, it will hardly be possible to find a more affordable analogue. Midecamycin is one of the most modern antibiotics, so the pharmaceutical industry has not yet had time to release many drugs based on it, as is the case with its predecessor, azithromycin.

Flemoxin Solutab from sinusitis

Flemoxin Solutab is the most popular trademark today, under which the well-known antibiotic of the penicillin series amoxicillin in the form of trihydrate is produced for a long time. It is active against bacteria that most often cause acute sinusitis (Streptococcus pneumoniae, 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 causative agents of the disease 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 in comparison 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 chewable tablet that easily breaks into two halves with a pleasant tangerine-lemon flavor.

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 disadvantage 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" against antimicrobial therapy. The 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 can be successfully treated with unprotected amoxicillin, tablets will have to be taken 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 Flemoxin Solutab (up to 600 rubles, depending on the dosage), a full course of therapy will cost a pretty penny.

Isofra with sinusitis

Isofra is a local 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 causative agents of sinusitis (staphylococcus, E. coli and Pseudomonas aeruginosa, Klebsiella, enterobacteria, 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, therefore such 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 to use and side effects, because the active substance does not penetrate the gastrointestinal tract (and therefore cannot cause nausea or diarrhea, or stay 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 into each nostril, and for children - 3 times). Isofra has a subtle lemon scent, so the treatment of sinusitis and runny nose does not cause discontent 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 frequently diagnosed causative agents of acute sinusitis. Anaerobic microorganisms (peptostreptococci, bacterioids, fusobacteria) are also resistant to it, which also sometimes cause sinusitis, especially chronic and constantly recurring forms of it. Therefore, it is advisable to carry out a short 7-10-day course of treatment for sinusitis with Isofra, and if it does not work, switch to another drug.

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

Dioxidin with sinusitis

Dioxidine (hydroxymethylquinoxalindioxide) is a very broad spectrum antibiotic of bactericidal action, a derivative of quinoxaline. It is active against all strains of streptococcus and staphylococcus, Pseudomonas aeruginosa and Escherichia coli, Shigella, Salmonella, as well as pathogenic anaerobes. The causative agents of sinusitis, showing resistance 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, lies in 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, you can expect a radical improvement in well-being in the acute form of the disease in a week.

The second plus of this drug is a relatively affordable price - one ampoule will cost you about 50 rubles. Keep in mind, however, that once opened, it cannot be refrigerated for more than 24 hours. Therefore, the full course of treatment of sinusitis with this antiseptic, most likely, will take the entire package of 10 ampoules.

Minuses

Dioxidine is extremely toxic, and it is absorbed into the bloodstream through the mucous membranes with intranasal administration of the solution in volumes sufficient for the development of side effects. Therefore, the official instruction for the drug states that it is contraindicated for pregnant and lactating women, as well as for 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 a personal choice of parents.

The second disadvantage of Dioxidin is that by itself it does not completely cure sinusitis, therefore it is always prescribed as part of complex antibacterial therapy. That is, you will not only have to instill in your nose a potentially dangerous (and, by the way, terribly bitter) liquid, but also take antibiotics orally or by injection. It is obvious that this 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.

The author of the article: Lazarev Oleg Vladimirovich | ENT

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