Do You Need an Antibiotic for a Sinus Infection?

What to Know Before You Fill Your Prescription

A sinus infection.
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Sinus infections are a big pain, as anyone who’s ever had one can attest. A throbbing sinus headache can make you feel like your head is filled with cement. While you may want to reach for antibiotics to make you feel better, they may not be necessary. Here's what experts say about antibiotics for sinus infections.

What Causes Sinus Infections?

Almost one in seven people get a sinus infection each year, and they may be more likely to happen as you age, according to the American Academy of Otolaryngology.

People who have allergies, asthma, structural blockages in the nose or sinuses and people with weak immune systems are at the greatest risk for getting a sinus infection.

They're often caused by either a bacterial infection, viruses, or fungus/molds. People with weak immune systems are most likely to develop sinus infections from bacteria or mold. Understanding the cause of your infection is important, as it should determine what kind of treatment you use to get better.

When to Use Antibiotics

American spend $150 million on prescription medications for sinus infections every year, and many of those prescriptions are for antibiotics. However, antibiotics are designed to hinder the growth of bacteria, so they're only effective for treating bacterial infections, not viral infections. If your doctor has pinpointed a bacteria as the cause of your infection, then antibiotics are likely the right choice of medication for you.

When to Avoid Antibiotics

In 2012, new guidelines were issued for physicians treating sinus infections, authored by an 11-member panel that included experts from the US Centers for Disease Control and Prevention (CDC) and the American College of Physicians. Published by the Infectious Diseases Society of America (IDSA) in the journal Clinical Infectious Diseases, the recommendations warn against using antibiotics to treat the problem.

The reason? The position paper says as many as 98 -percent of these infections are viral. And, as mentioned above, a virus will not be cured or even helped with the use of antibiotic medications.

The IDSA guidelines also discourage the use of decongestants and antihistamines, saying they may make symptoms worse. In addition, they recommend non-drug practices like nasal irrigation with saline solution. In the rare event that stagnant or persistent congestion in the nasal passages becomes infected with bacteria, the panel suggests using antibiotics for a shorter period of time, such as five to seven days, rather than the typical 10-day treatment course.

Many health agencies, including the World Health Organization, have warned of the dangers of over-prescribing antibiotics, which can lead to the development of resistant bacteria, or superbugs.

The Takeaway

Understanding the cause of your sinus infection is the key to appropriate treatment. If you have a bacterial infection, then antibiotics are a good choice. But if you have a viral infection, an alternative treatment is more appropriate for you.


American College of Allergy, Asthma & Immunology. (n.d.). Sinus Information.

Anthony W. Chow et al. "IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults."Clin Infect Dis. (2012) doi: 10.1093/cid/cir1043.