Sidelined by a Sinus Infection? Our Take on Antibiotics

Updated July 9. 2025

If you’ve had a sinus infection, you’re familiar with the symptoms: nasal congestion, fatigue, throbbing pressure, and pain around your face and head–even your teeth ache. Sudden movements or bending over can exacerbate the sensations, leaving you wincing in pain, sometimes even causing dizziness. When a sinus infection hits, your instinct might be to seek medical attention. In fact, the American College of Asthma, Allergy, and Immunology estimates that Americans spend $150 million per year on prescription medications seeking relief for their sinus woes.

While there are some medications that can help ease the discomfort, antibiotics typically aren’t recommended at the start. That’s because about 98% of sinus infections are caused by viruses rather than bacteria—and antibiotics don’t work against viruses. What’s more, over 99% of sinus infections, whether viral or bacterial, clear up on their own within two to four weeks.

Rather than turning to antibiotics, the best way to handle most sinus infections is to focus on relieving your symptoms as your body heals. Here are some simple, effective ways to reduce the pain and discomfort while you recover.

Sinusitis is caused by inflammation of the mucous membranes in the nose and sinus cavities around the eyes, nose, and cheeks. As these membranes swell, they block the normal flow of mucous through the sinuses and nasal passages. This result is pressure and pain that radiates from the inflamed areas.

One effective way to manage sinus infection symptoms is to open up the pathways so that trapped mucous can drain. Nasal irrigation is an effective way to help improve sinus pressure. At the first sign of congestion, rinse your nasal passages and sinuses with a salt-and-water mixture (1 teaspoon salt to 1 pint warm water) to help unblock your sinuses and expel trapped matter. Sinuses can be rinsed twice a day–first thing in the morning and in the evening–and more often if it doesn't cause irritation. Saline nasal rinse kits are available over-the-counter at retail pharmacies.

• Over-the-counter decongestants can provide relief when sinus pain is at its worst. Afrin (oxymetazoline) is an option for a nasal spray decongestant, but shouldn't be used for more than three consecutive days. Sudafed is an effective oral decongestant, but shouldn't be used by people who have high blood pressure or heart disease.
• Steroid nasal sprays such as Flonase (fluticasone) or Nasacort (triamcinolone) can help control sinus inflammation.
• Daily 10-minute steam inhalations can help make sinus pressure feel better. A few drops of eucalyptus oil may be added if desired.
• Holding warm compresses over the sinuses can relieve pain.

For most of us, self-care is the only treatment that’s needed. Keep in mind that antibiotics can disrupt the healthy bacteria in your gut, causing diarrhea and abdominal pain. They’re also notorious for causing yeast infections and, occasionally, serious allergic reactions, so we only want to use these medications when necessary.

So when should you check in with your provider? If your symptoms persist longer than 10 days, get significantly worse after 7 days, or worsen after a brief period of improvement, we suggest you reach out to your healthcare provider. You should also see a provider urgently if you have severe symptoms, such as a prolonged fever of 101 degrees F or higher, difficulty breathing, chest pain, difficulty swallowing, severe headache or stiff neck.