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Should sinusitis still be treated with antibiotics now?

Hello,

about 4 weeks ago, I had a simple cold (viral) that lasted for 10 days. Then I suddenly had deep yellow mucus in my sinuses, some pressure on my eye, and briefly also pain in my frontal sinuses... typical sinusitis. I went to the ENT doctor, and the diagnosis was a clear bacterial infection of the sinuses (ethmoid and frontal sinuses). He said I could wait a bit, as the antibiotic (Amoxicillin) was only necessary if I had severe pain, but he prescribed the medication just to be safe. After about a week with headaches and eye pressure, it got better. My frontal sinuses and sinuses are no longer painful, no headaches, but there is still yellow mucus and I still sound congested, meaning the mucus must still be somewhere (my nose is mostly clear, and my sense of taste and smell are okay, I just need to blow my nose occasionally). For days now, I have had no pain and I feel relatively good, but I still sound congested (nasal voice). In the mornings, quite a bit of mucus comes out (which is also bloody (bloody "threads" or bloody crust), otherwise the mucus during the day is not bloody), and during the day, some yellow mucus still comes out. When I bend forward, I no longer have headaches or pressure in my head (which is typical for sinusitis). Now my question: Can I just continue to wait, or is there a risk of the sinusitis becoming chronic, despite almost being symptom-free? The bloody mucus in the morning worries me a bit, but I think the mucous membranes in my nose/sinuses are severely affected by the infection. I would prefer not to go to the doctor again. However, I definitely don't want it to become chronic or for my mucous membranes to be permanently damaged. Is the antibiotic still effective now, or should I just wait? How do you interpret my symptoms?

Dr. med. Frauke Gehring

Good day,

Bloody mucous membranes are more likely to indicate a viral infection, as viruses can make the blood vessels slightly fragile. I do not see any reason for taking antibiotics, as you seem to be almost recovered on your own. In fact, most people with sinusitis rarely need antibiotics.

I would recommend using Bepanthen nasal ointment to care for your nose and advise you to have some patience. In another two weeks, there should be no more bleeding. If bleeding persists, further examination by an ENT specialist would be necessary.

Get well soon!

Warm regards, Dr. Höllering

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Dr. med. Frauke Gehring

Dr. med. Frauke Gehring

Arnsberg

Staatsexamen 1984 in Kiel, seit 1992 in eigener Praxis niedergelassen. Onlineberatung seit 2001 bei Almeda, Focus (als ärztliche Leiterin), Onmeda, Bild der Frau. Moderatorin, Dozentin für medizinische Themen.

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