The course of drug treatment of sinusitis is determined by the doctor after clarifying the form of the disease and the patient's condition. A common cause of acute inflammation in the sinuses is an acute viral or bacterial infection of the respiratory tract. The selection of the correct therapy and medications, the regular conduct of therapeutic measures will help completely cure the disease.
What is sinusitis?
The maxillary sinuses are located near the nasal passages and are connected to them by the outlet holes (anastomosis) with a diameter of 1-3 mm. With the onset of infection and the onset of inflammation, the nasal cavity swells, blocking the openings leading to the sinuses. In this blocked part of the maxillary cavity, white blood cells accumulate, which begin to fight the infection, which gives rise to an acute form of catarrhal sinusitis. At this stage, treatment started on time gives a chance to avoid further complications.
If the patient missed the onset of the disease and did not contact the laryngologist in time, then the dead leukocytes accumulate in the sinuses, "fermentation" begins, which is called purulent inflammation. In this situation, treatment must be started urgently, taking into account the knowledge of which drugs are used for sinusitis. After all, the brain is located nearby, which is dangerous for the patient with serious complications, and even for his life.
Therapy of sinusitis: general rules
After examining and establishing the cause of the disease, the doctor prescribes a comprehensive treatment that will help to overcome the infection that has entered the body, alleviate the patient's condition and avoid further relapses. Effective drugs for sinusitis help to destroy the infection, get rid of a cold. They can also relieve swelling of the nasal mucosa, reduce headaches, improve the patient's condition, bring down the temperature.
The complex drug treatment of sinusitis in adults consists of a set of several types of drugs, such as:
- antibiotics
- anti-inflammatory drugs;
- antihistamines;
- vasoconstrictive sprays and drops in the nose;
- antipyretic;
- immunostimulating agents.
All of the listed sinusitis medications, which act in a complex manner, will help relieve inflammation and cure the disease without using a maxillary sinus puncture ("puncture"), which is used for severe forms of purulent sinusitis.
Sinus Rinse
The very first step in the treatment of sinusitis is the procedure for removing pus and inflammatory products from the sinuses and nasal cavity. In a hospital setting, this is usually done using the cuckoo or the Proetsu method. Its effect is that a therapeutic solution is poured into one nasal passage, and the contents are sucked off from another by vacuum.
During the procedure, the patient should repeat the words "cuckoo" to exclude the possibility of fluid getting into the throat, hence the "folk" name. In order to carry out the procedure at home, auxiliary products can be used, using saline for pouring. Also in the pharmacy you can buy a special set "Dolphin", consisting of a bottle with a tube, nozzle and dispenser on the lid. Disposable packs with a herbal-mineral product intended for washing the sinuses are also sold in the kit.
With dolphin sinusitis, it helps not only wash the accumulated mucus, but also remove bacteria, dust and other harmful substances, after which the patient’s breathing is fully restored. The composition of the washing fluid includes a complex of minerals, as well as plant extracts of wild rose and licorice, which have an antiseptic, anti-inflammatory and immunosuppressive effect.
Before you start taking the contents of the bag should be dissolved in boiled water, the procedure itself is absolutely safe for the nasal mucosa and does not cause discomfort.
Means "Dolphin" is available in 3 types:
- for adults - a set of a special device (volume 240 ml) and 10 or 30 bags of washing liquid;
- for children from 4 years - a bottle of 120 ml and 30 bags of 1 g each;
- Separately sold sets of mineral products in bags for children of 1 g and for adults of 2 g.
Antibiotic use
With inflammation in the maxillary sinuses, it is necessary to stop the process of reproduction of pathogenic bacteria as soon as possible and prevent the infection from entering the sinuses. For this, ENT specialists apply a course of systemic or local antibiotics.
To accurately determine the causative agent of the disease, a smear is taken from the nasal cavity, Gram stain is done, and then bacteriological culture and analysis for sensitivity to various types of drugs are performed. Most often, sowing is done with a chronic form of the disease, which is not amenable to therapy with standard effective treatments for sinusitis - broad-spectrum antibiotics.
With the right drug, the positive effect of treatment occurs within 2-3 days, this is a decrease in temperature, a decrease in headache and compression in the forehead and nose, and an improvement in well-being.
Modern effective antibiotics for sinusitis are drugs of several groups:
- aminopenicillins (Ampiside, Libacyl, Sulbacin, etc.);
- amoxicillin clavulonates ("Augmentin", "Amoxiclav", "Rapiclav");
- macrolides (Sumamed, Azitroks, Elroks, Kistrotsin);
- cephalosporins (Zaftera, Maxipim, etc.);
- fluoroquinolones (Levostar, Zanocin, Sparbact, etc.).
In parallel, it is necessary to take probiotic preparations to normalize the intestinal flora (Linex, Bion-3, Normoflorin, etc.).
Nasal drops
The task of vasoconstrictive drops or sprays (decongestants) is to eliminate swelling of the nasal mucosa and adjacent sinuses, relieve congestion, and facilitate breathing. They are recommended to be used only in the early days of the disease in order to alleviate the condition, to be able to "freely" breathe for several days. For more professional therapy, you should consult a doctor to clarify the form of sinusitis and apply more effective treatments.
The therapeutic effect of nasal decongestants is as follows:
- fight against germs and infection;
- improving the outflow of secreted secretion;
- restoration of the functions of the ciliary epithelium;
- liquefaction of mucus and its removal to the outside;
- moisturizing the mucosa and relieving the general condition;
- narrowing of blood vessels and removal of edema.
The main types of inexpensive nose drops from sinusitis are distinguished by the active substance:
- xylometazoline (preparations "Otrivin", "Galazolin" and others) - the price is 40-100 rubles;
- phenylephrine ("Vibrocil") - complex drops that have an antihistamine and vasoconstrictive effect, can be used in children, the price is about 300 rubles .;
- nafazolin ("Sanorin") - allowed for use by children from 2 years old, costs 40-80 rubles .;
- oxymetazoline ("Nazol" and "Nazol-Baby") - allowed for children, price 180-240 rubles.
- "Rinofluimucil" - a spray that has a mucolytic, anti-inflammatory and vasoconstrictive effect, 280 rubles.
The disadvantage of decongestants is the short-term effect, which usually lasts from 2-3 hours ("Sanorin", "Naphthyzine") to 12 hours ("Nazol", "Nazivin", etc.).
For the treatment of the acute form of the disease, hormonal or nasal drops with an antibiotic are prescribed. With sinusitis, they well remove inflammation and destroy the cause of the disease. They are prescribed by the doctor only after clarification and diagnosis of the bacterial nature of the disease. Such drugs include Nazonex, Flixonase (contain hormones); Isofra, Polydex, Sofradex, Garazon, Protargol, Fluimucil (antibiotics), etc.
Recommendations for the use of drops for sinusitis
The choice of drugs for sinusitis in the form of sprays and drops in the nose depends on the symptoms of the disease and the negative associated symptoms:
- with dry nose and copious secretions, saline-containing products are used, for example, Aquamaris, Salin, which help moisturize the mucosa and eliminate mucus;
- with pus secretions, it is necessary to use antibacterial agents, they should be prescribed by a doctor after examination;
- when dry secretion is accumulated in the sinuses, mucolytics are prescribed to dilute it;
- if the patient has difficulty breathing, ordinary vasoconstrictive drops are suitable for "salvation";
- for children and pregnant women it is better to use special drugs that are approved for a given age and condition or folk remedies;
- when no drops already help, then the puncture of the maxillary sinus is used as the "last" remedy, surgery is possible.
Nasonex and other hormonal drops
The drug belongs to the group of local hormonal drugs based on corticosteroids and is intended for the treatment of inflammatory processes in the nasal passages and sinuses. "Nasonex" for sinusitis in adults is used only after consultation with a doctor, because it contains the hormone mometasone. This is a strong hormonal substance that has an inhibitory effect on the inflammatory process on the nasal mucous membranes when applied topically.
The medicine is available in the form of a suspension, which must be shaken before use. Injection is carried out using a special dispensing nozzle.
The action of Nazonex is as follows:
- reduction of mucosal inflammation by blocking mediators;
- removal of edema (vasoconstrictor action), which allows the nose to breathe freely;
- anti-allergic effect, which is associated with the blocking of receptors on the mucous membrane, reacting to the irritating effect of the allergen.
The drug is recommended for use in sinusitis, complicated by the influence of pathogenic bacterial infections, in combination with antibacterial drugs. When pus is excreted from the nasal passages, it is recommended that they be thoroughly rinsed first.
The dosage of "Nazonex" for adults is 2 injections twice a day, for children from 2.5 years - 1 injection 1 time per day. The drug has contraindications (individual intolerance to the components) and negative side effects in the form of nosebleeds, discomfort, headache, increased eye pressure, therefore it is used only after consulting a doctor.
Similar drops and sprays for the medical treatment of sinusitis with glucocorticosteroids are recommended for treatment of exacerbation of the chronic form of the disease:
- "Flixonase" (contains fluticasone) - used in adults and children from 5 years of age;
- "Avamis" - is used once a day (in the morning) in adults and children over 4 years old.
Sinuforte
The action of Sinuforte nose drops is based on the ability of the active substance - cyclamen from the saponin group - to accelerate secretion secretion, which lubricates the mucous membranes of the nasal cavity, which helps the viscous thick mucus to escape.
"Sinuforte" with sinusitis helps cleanse the nasal cavity and sinuses from pus, restores drainage and their ventilation. The medicine package contains vials of powder and liquid extract of European cyclamen, after connection they need to be shaken, screw on the dispenser cap, with which the medicine is sprayed into the nasal passage.
Instructions for use are as follows:
- after preparing the solution, remove the cap and make a test spray into the air;
- during the procedure, the head should be kept straight, enter the upper part of the dispenser into the nasal passage and spray into each sinus;
- after 2-3 minutes, the medicine begins to act: there is an active secretion of mucus and lasts up to 2 hours;
- pus comes out at first, gradually the discharge becomes more transparent;
- after cleansing the nasal sinuses, normal breathing is restored;
- injection is carried out every 1-2 days at a dose;
- Duration of treatment - 8 days with a daily procedure and 16 - when applied every other day;
- after 6-8 procedures, a complete recovery is possible.
Contraindications to the use of Sinuforte:
- high sensitivity to the active substance (cyclamen);
- allergic rhinitis;
- high blood pressure (hypertension);
- children under 12 years old;
- pregnancy and lactation.
Sinuforte should not be taken simultaneously with local anesthetics. Also, the drug is also available in the form of drops, which are injected into the nasal passages using a special atomizer on the bottle.
Spray and drops in the nose "Polydex": instructions for use
A positive therapeutic effect that drops with antibiotic content have in the treatment of sinusitis:
- a decrease in the volume of purulent discharge;
- decrease in concentration and destruction of pathogenic microorganisms;
- inhibition of inflammation on the nasal mucosa.
One of the commonly used drugs in the form of a spray or drops is Polydex. Instructions for the use of drops in the nose recommends using the medicine 5 times a day, injecting 1 time (for adults), or three times a day (children 2-16 years old).
It consists of:
- phenylephrine, which constricts blood vessels and facilitates breathing through the nose;
- dexamethasone - hormones that help destroy the pathogenic flora and stop the inflammatory process;
- neomycin and polymyxin are antibacterial agents.
Contraindications to the use of "Polydex" are hypertension, allergic reactions, glaucoma in a patient, a tendency to seizures.
"Isofra": instructions for use for children and adults
This drug is most in demand, due to its effective action and the possibility of use in children. It relates to local remedies for the symptomatic treatment of ENT diseases. The composition includes framycetin sulfate, which has strong antibacterial activity and the ability to destroy bacterial cells with a violation of their metabolism. Its action is effective against gram-positive and gram-negative pathogenic bacteria that multiply in the upper respiratory tract.
Recommendations for use:
- adults - 1 injection every 4-6 hours;
- according to the instructions for use "Isofra", for children older than 1 year, 1 dose is injected three times a day;
- the course of treatment is 7-10 days, depending on the severity of the disease;
- when injecting, the vial must be held upright.
In severe cases, with the threat of complications or with purulent sinusitis, the use of a spray should be combined with taking antibiotics inside or in injections. During pregnancy and breastfeeding, the use of Isofra is prohibited due to the negative impact on the formation of the baby’s hearing organs.
Treatment of sinusitis in children
For medical treatment of sinusitis in babies, it is best to use nasal drops, because the use of a spray or aerosol can provoke laryngospasm in a child who has allergic and other health problems.
Most of these drugs are contraindicated in children under the age of 2-3 years, because the formation of the maxillary sinuses in the child continues for the first 3-4 years. Therefore, treatment should be started by washing the sinuses with saline or the Aquamaris preparation for children; they are allowed even for babies almost from birth.
After 3 years of age, special children's types of drops are allowed for use, for example, Nazol-Baby and others. A doctor can prescribe hormones only from 3-4 years. Caution should be exercised when prescribing herbal preparations (Pinosol, Sinuforte), which, with individual intolerance, can cause allergic reactions.
The list of drugs for the medical treatment of sinusitis is very long, so for a successful recovery it is best to contact a laryngologist who can correctly select the right medications that will help alleviate the general condition, relieve unpleasant symptoms of the disease and will contribute to its cure.