Update: October 2018
Since the days of rural medicine, when there was one for the whole district
the doctor whose primary specialization was surgery
the treatment of sinusitis was reduced to the principle “where pus is wider
open it. “
The wall of the maxillary sinus under local anesthesia
pierced with a wide needle or trocar, after which it was carried out
its drainage with pumping out of purulent contents.
This practice existed in the eighties of the past.
century, leading to the successful disposal of acute sinusitis, but
increasing the risk of recurrence that led to subsequent punctures and
the formation of chronic fistulous passage between the maxillary sinus and
With the advent of a large number in the pharmacological assortment
various antiseptics and antibacterial agents, treatment
antritis has moved to a new level of quality and is now in progress
most cases conservatively.
To the credit of modern otolaryngology, it should be noted that the rejection of
surgical path has led to very decent results, as with
direct treatment of the disease, and in terms of remote
results. Much less chronic processes, much
less stress experienced by the patient, relieved from the need
painful and scary surgical puncture manipulation.
What are the real possibilities of medicinal treatment?
sinusitis today, and how to choose the least cheap and effective
medicinal kit (to treat sinusitis with one drug so far
not yet learned)?
What medications are used for sinusitis?
Since the basis of the inflammatory (catarrhal or purulent)
process in the maxillary paranasal sinus – infection (more often
microbial, rarely viral or fungal), then conducting treatment
antritis, antimicrobial drugs, antiviral drugs or
Antibiotics – любимое детище медицины 20 столетия, однако,
not the best cure for sinusitis. If treatment is carried out in
a clinic equipped with a decent laboratory and before
treatment of discharge of the sinus is sown to determine the causative agent
and its sensitivity to the antibiotic is a small matter.
It remains to choose the drug that shows the greatest
activity against the microbe. It should be borne in mind that
the result of the analysis (in vitro sensitivity) may not coincide with
the actual working conditions of the antibiotic in the body.
Therefore, immediately choose the strongest drug (in the absence of
contraindications and, first of all, allergic reactions to
him). Most often, antibiotics are prescribed empirically, that is,
empirically, on the basis of indications (the presence of yellow or green
discharge from the nose, the temperature reaction of the body). Wherein
selects a broad-spectrum drug that is active against
most potential causative agents of sinusitis.
They have already lost to the majority today.
microorganisms. And especially staphylococcus that are on
the third place among the causative agents of acute or chronic antritis
(after streptococci and hemophilic bacilli). However, often with
In the absence of seeding, therapy begins with inhibitor protection.
penicillins, which contain additional additives that prevent
bacteria destroy the drug. Plus, penicillins are still
effective in combating streptococcus, which is capable
cause severe complications of the kidneys and joints, and
secondary rheumatic valvular heart disease.
The most popular preformed tablets: Clavulatum
Amoxicillin under the trade names Panklav, Amoxiclav,
Flemoklav and powder for suspensions Augmentin. Sulbactam Ampicillin
with the names Ampixide in pills and injections, Unazin,
Amoxiclav is a combination of amoxicillin and clavulanic acid,
active against Staphylococcus aureus, pyogenic and
pneumonia streptococci, Escherichia coli, enterobacteria,
moraxella and klebsiella. Thus, covers most of
spectrum of potential causative agents of sinusitis. Pills drug
take in children at the rate of 40 mg per kg of body weight in three doses per
day., for persons over 12 years 1 tablet (125 mg + 250 mg) every 8
hours or pill (125 + 500 mg) every 12 hours. Course of therapy
is 7 days.
Cephalosporins второго (Цефаклор) и третьего (Цефтибутен,
Cefixime) generations due to widespread use today
moved and gave way to macrolides. However, in terms of budget
shortages and rising prices for medicines are still not gone
from the stage.
Cefixime (Supraks, Pancef, Zemideksor) – pills that suppress
hemophilus bacillus, streptococcus, moraxella, klebsiella).
Halved by the liver and kidneys. 400 mg of the drug are taken
once a day or in half dosage twice (in adults and
children over 12 years old). Side effects include skin allergies,
dry mouth, nausea, diarrhea, abdominal pain, pseudomembranous
colitis hepatic transaminases, dizziness, headaches,
drop in white blood cells and platelets, rarely interstitial
nephritis. The remedy is contraindicated in allergies to penicillins and
Macrolides (Азитромицин, Джозамицин, Кларитромицин) используются
in tablets and suspensions in children and adults in courses for 3-5 days.
They exhibit activity similar to inhibitor-protected penillins with
меньшей устойчивостью microorganisms.
Azithromycin (Azitral, Sumamed, Hemomitsin) tablets of 500 or
250 mg are used in the dosage of 500 mg once a day. Side effects
effects are similar to cephalosporins. Drugs are undesirable when
allergies to macrolides, are questionable when used in pregnant women and
These are drugs of adult practice only, as still
refer to reserve funds and should be used in extreme
cases that do not develop cross insensitivity to them
bacteria. They have the ability to kill bacteria by blocking their DNA.
Lomefloxacin (Lomefloks, Lomatsin, Xenakvin), Ciprofloxacin
(Infectipro, Quintor, Zindolin), Ofloxacin (Glaufos, Zanotsin,
Kiroll), Norfloxacin (Negafloks, Lokson), Levofloxacin,
Moxifloxacin, Sparfloxacin (Sparflo).
Local antibiotics splash in the form of a nasal spray:
Framycetin (from the group of aminoglyosides, Isofra). Medicine
used 4-6 times a day for 7-10 days.
These are the drugs of choice in the treatment of viral sinusitis. Because
most viral antritis are treated with antiviral drugs
expensive and useless (most of the tools do not have a solid
evidence base), the main goal for viral sinus –
provide a decent outflow from the sinus and try to sanitize
- Dioxidine in 1% solution. It is taken from the ampoule into a 10 ml syringe. Of
which is buried in the nasal passages, which may also
washed with the drug. The tool, in fact, is powerful
an antiseptic that kills most viruses and bacteria, which
it is undesirable to swallow “in order not to cause harm to the stomach.” In the nursery
The practice does not apply due to toxicity. For the same reasons
не применяется у беременных и nursing
- Miramistin – a chlorine-containing antiseptic of the widest spectrum
actions. It has no color, smell and almost taste. In adults
used for washing, and in children for instillation into the nose. Can
cause local allergies. Not contraindicated in pregnant and lactating.
Read more here.
- Furacilin in 0.02% solutions is used to wash the sinuses.
At home, the solution is prepared from two tablets and a glass.
water. For washing use a baby syringe or 20 grams
syringe. The ENT doctor uses a device consisting of
tube through which a solution is pumped into the nasal passage and suction for
its pumping out. A wash course consists of 3–10 procedures;
be complicated by otitis. Furacilin is bitter enough, but swallow it
in small quantities (which usually happens during rinsing)
- Protorgol is a silver solution very effective at
bacterial process in the sinuses, especially in children. Buries by
2-3 drops in each nasal passage for 7-10 days. For today
used infrequently under the pretext of the accumulation of silver ions in
the body and its chronic poisoning that fair
opinion otolaryngologists of the Soviet school, complete nonsense. Means
worked, works and will work while it is prepared in pharmacies.
Means годно в течение 2 недель при условии хранения в
Again, the Soviet experience, forgotten and crammed with antibiotic
pharmaceutical industry lobby. With staphylococcal or klebsielle
antritis in children’s practice and sustainable microflora – worthy
preparations for local use in the form of washes or drops in
Nasal wash solutions
Dolphin, Aquamaris, Salin, Aqualor – a clever publicity stunt,
selling saline (0.9% NaCL, that is, the solution
salt) for the price of decent antibiotics. Flush nose when
antritis is not harmful, it is harmful to pay for a solution of salt
fabulous money. So for a bottle of sterile saline volume
20 ml will have to pay no more than 40 rubles.
Read also on the topic:
- How to treat sinusitis at home
- Dolphin at the maxillary
- Symptoms of sinusitis in adults
- Sinuforte from antritis
- Causes of nasal congestion
- 11 rules – how to take antibiotics
- Treatment of antritis with antibiotics
At the same time a bottle of Aquamaris with a volume of 10 ml is worth
already more than 110 rubles, Salin 30 ml – from 137 rubles, and 30
Dolphin sachets for a gram of powder in each will cost 190
The same audience that patented physiological options
solutions are recommended as less safe (it is not clear why),
that is, children, generally washing the nose at home is not
due to high risks of secondary inflammation
A few words on how to wash your nose properly. Before rinsing
you need to stand over the sink, leaning at a right angle forward.
After a deep breath breathing is delayed. Rinsing tank
tightly applied to the nostril. Then slowly rises
so that the solution flows from the opposite nostrils. Washed
one, then the other half of the nasal passages and, if possible, the sinuses.
The remnants of the solution are removed from the nasal passages active
GeloMirtol and GeloMirtol Forte
This is an alternative to antibiotics in the fight against sinusitis. This
homeopathic remedy, oddly enough, works. It is effective
cure for antritis in combination with dioxidin can cure
acute unresolved antritis for a week. It is based on myrtol,
supplemented with cineolem, limonene, pinem, rapeseed oil.
The entire mixture is enclosed in a gelatin capsule, dissolving in
intestine. The drug has a weak antibacterial,
anti-inflammatory effect, and also improves the outflow of secretion from
sinuses and nose. Contraindicated in allergies to medication components,
bronchial asthma, gallstone disease, in the first trimester
pregnancy and in children under 6 years.
Drops may drip during sinusitis, but this should not be
anyhow, and the right drops:
- Clean vasoconstrictor agents for antritis; no dripping.
desirable. The duration of their application (with a strong
nasal obstruction (interfering with sleep) should be limited to five
for days. Means of this group: Xylometazoline (Otrivin, Galazolin,
Xymelin), Naphazoline (Sanorin, Naphthyzinum), Oxymetazoline (Nazivin,
- Much preferable to a mixture of essential oils (Sinupert,
Pinosol, Sinuforte) or combined drops: vasoconstrictor
Phenylephrine in combination with antiallergic phenystyle (Vibrocil)
or Rinoflucilil (acetylcysteine, which improves the outflow and
vasoconstrictor tiaminoheptana sulfate).
- Polidex is also possible (a vasoconstrictor with an antibiotic and
corticosteroid), Rinopront (antihistamine and vasoconstrictor),
Dr. Theiss Nazolin (eucalyptus oil and vasoconstrictor
- Sinuforte is cyclamen from antritis in the form of lyophilisate
extract and juice of tubers 2-3 drops sprayed into each nasal passage
once a day for two weeks. The drug is prohibited
pregnant and lactating. It can cause local allergies, therefore
Allergy Contraindicated. Also, it should not be used when
polyps in the nose and unregulated hypertension.
These are antipyretic and anti-inflammatory drugs (Nurofen,
Ibuprofen, paracetamol), as well as antiallergic agents 2 and
3 generations, reducing swelling of the mucous membranes of the sinuses and nose (Loratadin,
Desloratadine, Cetrin, Zinnerit, Claritin, Clarincens).
Thus, antibiotic treatment of antritis is not necessary.
condition of successful conservative therapy. It is much more important that
the edema was eliminated, the outflow of the contents of the sinus was adjusted, and was performed
local rehabilitation of the inflammation.