When is antibiotic treatment recommended for sinusitis?

Sinusitis commonly presents with blocked or runny nose, facial pressure, reduced smell and thick nasal discharge. Many episodes are linked to viruses and improve with supportive care, so antibiotics are not automatically useful. A clinician considers how long symptoms have lasted, whether they are severe, and whether they improved before becoming worse again. Examination of the nose, throat and face helps distinguish sinusitis from other causes of facial pain. The decision also takes account of pregnancy, allergies, other medicines and existing health conditions.

Arrange a review if symptoms are severe, persistent or worsening after an initial improvement. Rest, drink fluids and use saline nasal rinsing or prescribed symptom relief if suitable for you. If antibiotics are prescribed, take them exactly as directed and report troublesome side effects rather than changing the dose yourself. Avoid using decongestant sprays for longer than the product instructions, and do not use leftover antibiotics. A pharmacist or clinician can help choose safe pain relief when you have another medical condition.

Seek urgent help for swelling or redness around an eye, vision changes, severe headache unlike your usual symptoms, neck stiffness, confusion, weakness, or difficulty breathing. Same-day assessment is sensible when facial pain is intense, one side is rapidly worsening, or you are becoming generally very unwell. These warning signs can indicate spread beyond the sinuses and should not be managed by waiting for antibiotics to work.

Ask whether your symptoms fit bacterial sinusitis, which self-care measures are safe, whether an antibiotic is needed, how long to use it, and which changes should trigger urgent review.