How Long Do Antibiotics Take to Work on Sinus Infections?

If you've ever dealt with a sinus infection before, you know how frustrating they can be.

Symptoms are almost identical to the common cold and can leave you wondering if you need antibiotics. 

About one in eight U.S. adults are diagnosed with a sinus infection each year. Yet an estimated 90% to 98% of cases are viral, meaning antibiotics won't help in most cases.

How do you determine if you should seek care or if antibiotics are appropriate? And if antibiotics are prescribed, how long could it take before you get symptom relief? 

As a family medicine physician at PartnerMD, I see sinus infections frequently, especially during the fall and winter when colds, flu, and other respiratory illnesses are circulating. One of the biggest questions patients have is whether their symptoms are actually a sinus infection and, if so, whether they need antibiotics. 

The answer isn't always as straightforward as you might think.

In this article, you'll learn what to know about sinus infections and antibiotics, including:

• Antibiotics aren't needed for every sinus infection. They may be considered when your physician suspects a bacterial infection based on your symptoms and how long they last.
• Antibiotics can take two to three days to work. If prescribed, take them exactly as directed by your physician.
• Sinus infections can look a lot like a cold. The duration and progression of your symptoms can help distinguish between different types of sinusitis.
• Persistent symptoms may need another look. Contact your physician if symptoms don't improve after several days of antibiotics, worsen, or return after treatment.

When Are Antibiotics Prescribed?

Sinus infections can be caused by bacteria, viruses, fungi, or even allergies. Most clear up on their own without any medication. However, antibiotics may be recommended when your physician suspects a bacterial infection, particularly when symptoms are severe or worsen. 

This could include:

• Symptoms lasting more than 10 days
• A fever of 102° or higher
• Tenderness and pain in your teeth

Even then, antibiotics aren't always the first step. Depending on the severity of your symptoms and overall health, your physician may look at your medical history and recommend monitoring your current symptoms before prescribing an antibiotic.

If you don't need antibiotics, your physician may prescribe nasal rinses, decongestants, or anti-inflammatory medications to manage symptoms.

How Long Do Antibiotics Take to Work?

It can take between two to three days before antibiotics work for a sinus infection.

Once you start your antibiotic, take the medication exactly as prescribed, including the recommended dose and length of treatment. Don't stop, extend, or save antibiotics for later without talking to your physician.

Are There Any Negative Side Effects?

Sometimes, patients experience negative side effects while taking antibiotics. If you experience rash, hives, or have difficulty breathing, call your physician immediately in the case that you may be experiencing an allergic reaction.

Antibiotics can have effects beyond treating your sinus infection, including tendon inflammation in some older adults and changes to healthy bacteria in the gut.

How Do You Know If It's a Sinus Infection?

Your sinuses are the four paired cavities in your head connected by narrow passages around your eyes, nose, forehead, and cheeks.

A sinus infection, also called sinusitis, occurs when the tissue lining your sinuses becomes inflamed or swollen. This causes the small opening to be blocked and leads to mucus and fluid buildup.

Sinus infections can cause uncomfortable symptoms, including congestion, facial pain or pressure, headache, post-nasal drip, and a cough or sore throat. 

Because these symptoms overlap with a cold or other respiratory illness, the duration and progression of your symptoms can provide clues about when it's time to see your primary care physician:

• Acute sinusitis – Often caused by the common cold or allergy flare, with symptoms lasting 
  less than four weeks. About 90% to 98% of cases are viral and generally don't require antibiotics.
• Subacute sinusitis – Symptoms last four to 12 weeks, longer than acute sinusitis but not long enough to be considered chronic.
• Chronic sinusitis – Usually associated with ongoing sinus inflammation, with symptoms lasting 12 weeks or longer.
• Recurrent sinusitis – Four or more acute episodes occur per year, with symptoms clearing between infections.

What If Antibiotics Don't Work?

If your sinus infection symptoms do not improve after several days of antibiotics, become worse, or return soon after treatment, contact your physician. You may be referred to an Ear, Nose, and Throat (ENT) specialist for treatment if infections continue to recur or become chronic.

Looking For a Better Primary Care Experience? 

Primary care physicians are the best option for treating most sinus infections.

With traditional primary care, it may take weeks to get an appointment and long wait times with other potentially sick patients isn't ideal. 

If you're frustrated with your current healthcare experience, it might be time to consider a concierge medicine care model.

At PartnerMD, we provide same-day or next-day acute care appointments, 24/7 access to physician care, guidance from a certified health coach, and little to no waiting in lobbies or exam rooms. Learn how our smaller patient panels can make all the difference when it comes to your care.