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Thread: Azithromycin for sinusitus

  1. #1

    Default Azithromycin for sinusitus

    I have chronic sinusitis with recurring bouts of bronchitis. My doctor always gives me the same Zmax antibiotic because I have a penicillin allergy. The last two times I got sick he had to refill my script and I was down for around 3 weeks. I feel like it's not working anymore. Is anyone else having similar issues or maybe have had good results with another non penicillin based antibiotic ? Then I could make some suggestions to my doctor next time I get sinusitis.
    Thank you .

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  3. #2
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    Streptococcus pneumoniae, which is the most common cause of bacterial respiratory tract infections do develop resistance to antibiotics over time. I myself get several bouts a year, my doctor gradually increased the dosage. They could also switch to another antibiotic, Augmentin also works well for me....

    Years ago I had very good results with sulfa drugs, but developed an allergy over time....
    Last edited by scruffydog; 03-02-2016 at 08:19 PM.
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  4. #3
    I would highly suggest levaquin if it gets too bad and is confirmed to be bacterial sinusitis.
    Helpful Sassypat, freespirit75 Rated helpful

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    @Freespirit Vancomycin is a good AB. And a steroid inhaler or steroid nose spray may be helpful. All three of us here have been down this frustrating path. Have you ever tried saline rinses?

    - - - Updated - - -

    Quote Originally Posted by Vikingblood View Post
    I would highly suggest levaquin if it gets too bad and is confirmed to be bacterial sinusitis.
    @Vikingblood Same class of AB but different compound. Good call!
    Helpful freespirit75 Rated helpful

  6. #5
    Quote Originally Posted by Sassypat View Post
    @Freespirit Vancomycin is a good AB. And a steroid inhaler or steroid nose spray may be helpful. All three of us here have been down this frustrating path. Have you ever tried saline rinses?

    - - - Updated - - -



    @Vikingblood Same class of AB but different compound. Good call!
    I have tried saline rinses. I have a netty pot I use daily. They just prescribed me a steroid inhaler and I started nasonex about 2 months ago. Thanks for the information everyone. People that don't get these types of infections don't realize how much of an effect it has on your life and even your mental state. In 2015 I had four sinus infections and all of them caused bronchitis. The shortest lasted two weeks with the longest about 10 weeks. That was when I went to a specialist. And the funny thing was...after a CT scan my ENT said I still had some infection in my sinuses. It was pushing 12 weeks !!! I will definitely be talking to my doctor about those other antibiotics next time. It's to the point that everytime I sneeze I'm afraid I will be down for a month again. I'm sorry you guys have had to deal with this but it's nice to know I'm not the only one.
    People that aren't educated in this area tend to act like what's wrong with me they get a cold and are good in a few days. I try to explain that a bacterial infection is not so easy to get rid of and can do quite a bit of damage to your body. My ENT told me from all my sinus infections my sinus cavities have been reshaped.
    My spring project is ripping out all my carpet ,putting in laminate flooring and buying a whole house air purifier. I'm doing whatever I can to help at this point.
    Thanks again everyone

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    I would really hesitate to use Vancouver or Levaquin for sinusitis..
    Both can have horrendous side effects and should be saved for really bad infections...
    such as MRSA....
    Just read a journal article about this..
    My professional advice has always been. Our bugs are getting smarter than our drugs..i.e..resistance
    As for sinusitis...I used to prescribe Bactrim...14 days..if one is not allergic..
    Sinus infections are very likely virus so throwing antibiotics on it won't help anyway..
    Saline washes and steam can help a lot..gotta loosen up the gunk..
    My opinion only!

    Vancomycin!
    Last edited by AuntieRosebush; 05-16-2016 at 03:12 PM.
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  8. #7
    Quote Originally Posted by AuntieRosebush View Post
    I would really hesitate to use Vancouver or Levaquin for sinusitis..
    Both can have horrendous side effects and should be saved for really bad infections...
    such as MRSA....
    Just read a journal article about this..
    My professional advice has always been. Our bugs are getting smarter than our drugs..i.e..resistance
    As for sinusitis...I used to prescribe Bactrim...14 days..if one is not allergic..
    Sinus infections are very likely virus so throwing antibiotics on it won't help anyway..
    Saline washes and steam can help a lot..gotta loosen up the gunk..
    My opinion only!

    Vancomycin!
    I am not a physician (just a person who knows several people who have experienced nightmare side effects from Cipro and Levaquin), but I have to agree with @AuntieRosebush about avoiding Levaquin for sinusitis unless there really is no other option. Really, antibiotics shouldn't be prescribed until it's established that an infection is bacterial and not viral, as antibiotics have no effect on viral infections (for those you need antivirals, which have their own set of side effects). Some doctors still use Cipro and Levaquin as first-line antibimicrobials against sinusitis and other bacterial infections, but more and more information is coming out about the severe and sometimes permanent effects these drugs can have on tendons and on the central nervous system (tendinitis, tendon ruptures, peripheral neuropathies, other nasties). A majority of patients who are prescribed Levaquin don't experience these effects, but a sizeable minority do and if you're among that sizeable minority the side effects from these drugs can wreak permanent havoc on your life. There was a story not long ago about a band director in Minnesota who, after taking Levaquin and prednisone for a persistent sinus infection, ended up wheelchair-bound, is not recovering and may not recover. And there are many similar stories out there. The scary part is, many or most doctors are not aware of the frequency of adverse effects to this particular class of antibiotics and to this combination of drugs. As for myself, I'd only agree to take Levaquin as a last resort for anything. It's a powerful antmicrobial that can do a lot of good, but it can also do a lot of harm.
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    @Ellyn

    Levoquin was a complete nightmare for me. Never again.

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    I was recently diagnosed with a sinus infection.
    I just thought my allergies were really bad this year.
    Doc said that although my eosinophil count was high, he didn't think it had led to bacterial yet.

    I was rx'd a steroidal nasal spray.
    After walking out of the pharmacy laughing when they told me the spray was $ 300.00, I decided to try Flonase nasal spray instead. I called doc and asked for something else and Mr. Personality said there was no substitute.

    Anyway, the Flonase is working wonders!
    It's otc and affordable. I was also rx'd Claritin ( loratadine )
    pills but I think they are a bit too weak for me.

    When I go for my recheck hopefully they won't decide to rx antibiotics. Feeling better so I'm thinking no.
    If I have to see him again we are going to have words.
    He can shove that 300.00 nasal spray.

    Good luck with your antibiotic dilemma. You've gotten some good advice above. *
    Last edited by Moon Shade; 05-21-2016 at 02:26 PM. Reason: Sky is blue.

  11. #10
    Quote Originally Posted by Sassypat View Post
    @Ellyn

    Levoquin was a complete nightmare for me. Never again.
    I am so sorry you had a rotten experience with it. You already know you're far from alone in that, although it's a club you'd never want to join. I feel so strongly about fluoroquinolones that I actually have it on my medical ID card, and when I am traveling I wear a Medical ID bracelet, that says NO FLUOROQUINOLONES (I wear the bracelet at other times as well). I've had issues with knee and shoulder tendinitis and anyone who has any history of tendon problems should not take these drugs, other than as a last-ditch effort against a bacerial infection that's trying to kill them. One of my children has medical issues that contraindicate fluoroquinolones, as does my husband, so it's on their wallet cards also. And my other child knows to not fill a script for one of these drugs without asking about side effects and asking whether there are alternatives - and a doctor who won't talk about alternatives (including explaining WHY there isn't an alternative in a particular case) is not the doctor you want to see anyway.
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    Quote Originally Posted by Ellyn View Post
    I am so sorry you had a rotten experience with it. You already know you're far from alone in that, although it's a club you'd never want to join. I feel so strongly about fluoroquinolones that I actually have it on my medical ID card, and when I am traveling I wear a Medical ID bracelet, that says NO FLUOROQUINOLONES (I wear the bracelet at other times as well). I've had issues with knee and shoulder tendinitis and anyone who has any history of tendon problems should not take these drugs, other than as a last-ditch effort against a bacerial infection that's trying to kill them. One of my children has medical issues that contraindicate fluoroquinolones, as does my husband, so it's on their wallet cards also. And my other child knows to not fill a script for one of these drugs without asking about side effects and asking whether there are alternatives - and a doctor who won't talk about alternatives (including explaining WHY there isn't an alternative in a particular case) is not the doctor you want to see anyway.
    I never knew or heard about it when it was Rxed. I felt like I was in a horrible la la land. After one dose, I was off. Personally, I never knew of this class of antibiotics. I guess we were too engaged in getting a MRSA treatment out. Thanks @Ellyn . Good to know I am not alone. And whenever any doc mentions it for a bacterial infection--whether for me or my kid--I turn it down and ask for alternatives. I need to look up the structure of Levoquin.

    - - - Updated - - -
    @Ellyn Are there more in that class? I can look it up too. A must do.

  13. #12
    The most commnly prescribed ones are Levaquin, Cipro and Avelox. All should be antimicrobials of last resort and not first-line drugs against common infections. In fact, the FDA issue guidance just about a week ago recommending that these antibiotics NOT be prescribed for ordinary sinus infections, UTIs and bronchitis if other treatment options are available as the risk of serious side effects is just too high to justify their use except in cases of really resist bugs. Here's a quote (3 paragraphs of a quote, in fact) from the new FDA advisory:

    "The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolones should be reserved for those who do not have alternative treatment options.

    An FDA safety review has shown that fluoroquinolones when used systemically (i.e. tablets, capsules, and injectable) are associated with disabling and potentially permanent serious side effects that can occur together. These side effects can involve the tendons, muscles, joints, nerves, and central nervous system.

    As a result, we are requiring the drug labels and Medication Guides for all fluoroquinolone antibacterial drugs to be updated to reflect this new safety information. We are continuing to investigate safety issues with fluoroquinolones and will update the public with additional information if it becomes available."

    So, strong words for a strong antibiotic/antimicrobial, useful for the most resistant infections but not appropriate for garden-variety infections. There are those who believe that drugs in this class are so dangerous they should be pulled completely, which would probably be a mistake as there are circumstances in which really powerful antimicrobials are needed. But there are a LOT of people - well into the tens of thousands, if online sources are correct - whose lives have been upended or simply ruined because they were prescribed these drugs (often with prednisone, a BIG no-no) for a stubborn sinus infection or a urinary tract infection. The true number of people who have been seriously injured by fluoroquinolones is probably underreported because (again, according to online reports as well as formal testimony) doctors often don't believe their patients when the patients say that the problems began during or shortly after a course of these drugs.

    Anyway, I'll neither take fluoroquinolones myself nor allow a member of my immediate family to take them unless we're dealing with a REALLY serious infection and there is simply no other viable choice. They're necessary for some things, but they shouldn't be prescribed or taken if reasonable alternatives are available.
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    sad to see I'm not the only one who suffers from sinus infections several times a year. Sinus surgery 15 months ago. Rhinoplasty and deviated septum. Recovery was hell. Three back to back infections. Felt improvement 6 months later. For some reason I've slipped back into sinus problems. Not as bad as pre surgery I can't complain.

    being proactive seems to be the key for me. As soon as I feel it coming on I quickly use flonase,sudafed and mucinex d. Saline nasal spray several times a day. If I let the mucus settle for even one day I'm doomed.
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    One of my clients had to stop taking it because of severe stomach pain and cramping. He says it took him about a month to get back to normal state. He was suffering all that time, I don't know whether it is the best option in your case. Considering it has a lot of limitations.

  16. #15
    I have the same issue, I am on Flonase and also recently was put on a different antibiotic Augmentin

  17. Hopefully bumping this old thread won't be a big problem. I also have chronic sinus infections and have since I was a kid, and live in a town with only one ENT who has shrugged me (and others) off while refusing treatment.

    Azithromycin will work for sinus infections but it's not really the antibiotic of choice, from what I can tell. Augmentin is what most doctors prefer, but I was given amoxicillin (which is in augmentin) so many times as a kid in the 1970s and 1980s it no longer works for me. I'm allergic to sulfa antibiotics, so I'm limited in what I can use. My GP prescribes zith but this last year I've felt it hasn't worked very well.

    For OTC treatment, I recommend nasal rinses with saline packets in 8 oz distilled water, plus 1 to 2 oz. Alkalol and/or about 5 drops grapefruit seed extract added. Had some very good luck with 1/2 teaspoon birch-sourced xylitol powder in my rinses, too. That breaks up the biofilm which hides/protects the bacteria, and helps your rinse water get to the actual bacterial colonies and kill them or at least remove them.

    Lots and lots of fluids, no caffeine or dehydrating drinks, Mucinex or similar, and humidity. Flonase is OTC now and works pretty great, as does Rhinocort.

    Still, even if I'm working hard to stay on top of the situation, I'll get an infection 2-3 times per year. Not sure I'll ever find a way out of this problem, doctors really don't take it seriously.
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  18. Quote Originally Posted by jacksonhole View Post
    Hopefully bumping this old thread won't be a big problem. I also have chronic sinus infections and have since I was a kid, and live in a town with only one ENT who has shrugged me (and others) off while refusing treatment.

    Azithromycin will work for sinus infections but it's not really the antibiotic of choice, from what I can tell. Augmentin is what most doctors prefer, but I was given amoxicillin (which is in augmentin) so many times as a kid in the 1970s and 1980s it no longer works for me. I'm allergic to sulfa antibiotics, so I'm limited in what I can use. My GP prescribes zith but this last year I've felt it hasn't worked very well.

    For OTC treatment, I recommend nasal rinses with saline packets in 8 oz distilled water, plus 1 to 2 oz. Alkalol and/or about 5 drops grapefruit seed extract added. Had some very good luck with 1/2 teaspoon birch-sourced xylitol powder in my rinses, too. That breaks up the biofilm which hides/protects the bacteria, and helps your rinse water get to the actual bacterial colonies and kill them or at least remove them.

    Lots and lots of fluids, no caffeine or dehydrating drinks, Mucinex or similar, and humidity. Flonase is OTC now and works pretty great, as does Rhinocort.

    Still, even if I'm working hard to stay on top of the situation, I'll get an infection 2-3 times per year. Not sure I'll ever find a way out of this problem, doctors really don't take it seriously.
    Seem to have a chronic condition as well but hard to tell as allergies can cause similar symptoms. I always know that when headaches increase above the side of the eye is when it might be something more severe. Azithromycin seems to work for me but really only take it every few years.
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    Quote Originally Posted by otherone View Post
    Seem to have a chronic condition as well but hard to tell as allergies can cause similar symptoms. I always know that when headaches increase above the side of the eye is when it might be something more severe. Azithromycin seems to work for me but really only take it every few years.
    Same/same. The dr. I used to see went through two different courses of antibiotics which failed completely. Then one of my co-workers who's wife is an RN gave me a few sample paks of Zithromax. Within two days, ALL clinical symptoms pain, bleeding out me nose and into my throat were ceased. A 4 day course: Day 1 2x250 mg. caps followed by 3 days of 1 250 mg. capsule. That ended it. Completely. Had no idea sinus infections could be that steady pounding pain which felt like the front of me face would explode, and as you say intense headaches too. The first dr. ran an allergy panel that returned not one hit. My friends wife told me Zithro/Azithro more than other some antibiotics shouldn't be run for extended periods as associated gram negative bacteria can mutate into resistance with this antibacterials efficacy. If antibiotics fail she told me the alternative would have been pretty much endoscopic sinus surgery which from her describing it glad I didn't need. Glad it works for you too.
    Last edited by gitmein; 10-21-2018 at 03:54 PM. Reason: dosage

  20. #19
    I take septrin (co-trimoxazole) long term and found it helped I've never had a sinus infection since. I take this antibiotic has a preventative has I've had sbp twice but I find it helps keep a lot of infections at bay.

  21. Azithromycin for sinusitus

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