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Pharmacy and Medications

Doxycycline for sinus infections

05/21/2004

Question:

is this for sinus????

Answer:

Viruses cause almost all upper respiratory tract infections including those affecting the sinuses. Infections caused by viruses cannot be treated with antibiotics, and use of antibiotics for these patients is expensive, ineffective and increases the risk of bacteria becoming resistant to the antibiotics. Some patients with viral infections can develop a second infection caused by bacteria in their sinuses, and these patients may need antibiotic therapy to clear the infection. Patients who have allergies or who have sustained some sort of injury to their sinuses may be at increased risk of developing bacterial infections in their sinuses. Another name for this condition is acute bacterial sinusitis (ABS).

Making general recommendations for treatment of bacterial infections can be difficult because bacterial resistance patterns may vary in different areas. Treatment of ABS is based on a best guess of what will work. Determining the exact bacterial cause requires sticking a needle into the sinus and withdrawing purulent material. This is a procedure most physicians and patients would rather avoid.

Once ABS has been diagnosed, doxycycline is likely to be a reasonable initial treatment. It should work about 80 % of the time, and it is relatively inexpensive, well-tolerated, and only needs to be given twice daily. It is most useful in patients who are allergic to penicillin. Another medicine that usually works well in patients allergic to penicillin is Bactrim(sulfamethoxazole/trimethoprim). In patients who can take penicillin, a drug like Augmentin (amoxicillin with clavulanic acid) is probably a better choice for initial treatment. Augmentin is likely to be considerably more expensive than doxycycline. Other medicines may be needed for more severe or resistant cases.

Your doctor should be aware of the current recommendations for initial treatment of ABS as well as resistance patterns in your area. It is most appropriate to ask your doctor or a pharmacist who knows you about the medicines you take.

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Response by:

Robert James Goetz, PharmD, DABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati