The sinus inflammation is very common during upper respiratory infections - up to 90% - showing radiological signs, but only 0, 5-2% are complicated by bacterial infection. Acute bacterial sinusitis is defined as a sinus inflammation of the bacterial nature.
The bacterial sinusitis is bacterial superinfection consequence that follows after a viral nasopharyngitis trivial of upper respiratory tract, that affects in most cases, as previously mentioned, and sinus mucosa.
Aggression bacterial of at the level sinusal epithelium determine disappearance of ciliary movements, which, in normal, continuously evacuates mucus with bacteria present at this level. This situation favors the adherence and multiplication of bacteria at the level of epithelium, causing inflammation with edema of the lining and the obstruction of sinus drainage. The bacterium proliferates further and appear acute purulent sinusitis.
• sinus tumors
• foreign bodies
• septal deviations
Antibiotic treatment for bacterial sinusitis lasts 10 days and is usually empirically.
It is administered mainly:
• For localized maxillary sinusitis - amoxicillin - clavulanic acid, second generation cephalosporins (cefuroxime), third-generation cephalosporins (ceftriaxone), telithromycin
• for frontal sinusitis, ethmoid, sphenoid may be administered the above antibiotics or quinolone active on the pneumococcus, such as the levofloxacin, moxifloxacin
For sphenoidal sinusitis, which has severe evolution, is indicated association of injectable antibiotic with antistaphylococcal activity. In the absence of amelioration with antibiotic treatment is indicated surgical intervention for evacuation of pus.
In general, bacterial sinusitis evolves favorably under treatment with symptom control in 2-3 days.
Other means of treatment:
• steroidal anti-inflammatory
•-steroidal anti-inflammatory especially indicated in obstructive sinusitis (prednisone, prednisolone) in the short cure of a few days
• Pain Relievers
• sinus drainage by puncture - in case failed antibiotic treatment, with the persistence of radiological signs