Sinus infections develop about 10-14 days after the onset of an upper respiratory infection or with ongoing allergies. It is recognized by duration, day and nighttime cough, fatigue, headache, or persistent creamy nasal drainage (not just green mucus in the AM and face pressure). In addition, eyes may matter throughout the day and asthma may not respond to previously effective measures. Nosebleeds may be more frequent.
Prevention: Antibiotics are not essential to treat a sinus infection. Good nose blowing, saline flushes, and control of allergies may help avoid antibiotics. Neti pots are inexpensive and effective for chronic sinus problems (available at pharmacies).
1) If antibiotics are prescribed, finish the full course. If still coughing and congested at the end of therapy, call the office.
2) Looser, more productive cough is good! Encourage gentle but thorough nose blowing.
1) Acetaminophen (Tylenol) plus decongestant will relieve sinus pressure and headache better than either preparation alone. Reserve Ibuprofen (Advil, Motrin) for high temperatures or significant discomfit.
2) Decongestants to help promote drainage & relieve pressure. Use one of the following to promote drainage:
Sudafed (pseudephedrine) (OTC)
Robitussin PE or CF (Or generic), Mucinex D
Triaminic yellow or red (or generic)
3) Instill drops in each nostril (Ayr, Na-sal, Ocean Spray, etc). You may also let child play in a steamy shower or play submarine in the bathtub. Have older children sit over a pot of steamy water with a towel draped over the head. Saline drops can be made by adding ¼ tsp of noniodized (sea) salt to 1 cup boiled water (then cool). Neti pots or saline flush should be used daily for sinus cleansing.
4) Short acting nasal decongestant spray (Afrin, Neosynephrine, Otrivan) may be used to relieve significant congestions for no more than two days. Use after saline drops and decongestant to promote sinus drainage. Repeat saline as often as needed.
5) If allergies are chronic, clear out the nose (as above) then follow with steroid nasal spray (prescribed by pediatrician) in the morning.
6) Claritin, Zyrtec, Allegra, and Singulair can be continued. Generic or store brand is fine.
CALL THE OFFICE IF FEVER PERSISTS LONGER THAN 2 DAYS, HEADACHE BECOMES SIGNIFICANT, OR ASTHMA WORSENS.