Is my sinus infection immune to antibiotics?

Patients who get recurring sinus infections have real concerns about using so many antibiotics. They are not just concerned about the side effects and the cost but also the risk that these important medicines will no longer be effective. It's not actually the patient that becomes immune but the particular bacteria. Bacteria have sensitivity to some antibiotics and resistance to others. After repeated exposure to antibiotics the bacteria can actually learn to become resistant making the antibiotic ineffective. This is why it is important to follow some important steps when treating with antibiotics. Viral infections should not be treated with antibiotics. Your clinician can help you determine if the infection is bacterial. Treatment should be based on an accurate culture of the infection if possible. Nasal endoscopy can be used to accurately and painlessly obtain a sinus culture in the office setting by an ENT physician. Therapy should be long enough and strong enough to resolve the infection. Weak or short courses tend to create resistant bacteria. Confirmation that the infection has been resolved is also important. Frequently the patient will feel better but may still be carrying a low grade infection. Imaging or repeat culture can be done if there is doubt that the infection has resolved. Lastly, if the infections continue to recur quickly after treatment there must be an evaluation to see if there is an underlying chronic sinus infection with obstruction of the outflow tracts. Simple procedures such as balloon sinuplasty can resolve the obstruction and make the antibiotic therapy successful. Using these guidelines you can be assured that your antibiotic treatment will be effective and safe. Daniel Slaughter, MD