Treatment of frontitis with antibiotics: list of drugs, schemes

Frontal sinusitis is considered a relatively common pathology, which is an inflammation of the mucous membranes of the nasal frontal sinuses. In the early stages, the disease can be mistaken for a common cold, so most often patients seek medical help only when the inflammatory process becomes widespread - the temperature rises, a severe headache appears, etc. In such a situation, it is very important to correctly prescribe antibiotics for frontal sinusitis - only antibiotic therapy will help cure the disease and avoid the development of adverse complications.

Treatment of frontal sinusitis with antibiotics

Before taking an antibiotic for frontal sinusitis, it is necessary to make sure of its bacterial etiology, since frontal sinusitis can also be viral or allergic.

When choosing a drug, it is important to carefully study its pharmacological characteristics and make sure that its active component will get into the nasal sinuses. The resistance of pathogenic flora to antibiotic therapy is also of great importance.

Laboratory testing of nasal discharge allows identifying the bacteria and assessing their sensitivity to antimicrobial drugs. This will allow prescribing the medication that will be most effective in a particular case.

If for some reason it is impossible to evaluate resistance, then an antibiotic with the broadest possible spectrum of antibacterial activity is prescribed. The effectiveness of the prescribed therapy is determined 2-3 days after the start of treatment. If there is no positive dynamics of frontal sinusitis, the antibiotic is replaced with another one with a different spectrum of action.

Indications antibiotics for frontitis

Before starting treatment, it is necessary to undergo diagnostics to confirm the bacterial nature of frontal sinusitis. If the doctor indicates an allergic, fungal or viral nature of the disease, then prescribing antibiotics for frontal sinusitis will be inappropriate.

Thus, indications for prescribing antibiotic therapy for frontal sinusitis include:

• diagnosed bacterial etiology of frontal sinusitis;
• prolonged and severe fever;
• the presence of abundant purulent discharge from the nasal passages;
• critical deterioration in the patient's health;
• pronounced leukocytosis;
• period after otolaryngological surgery.

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Antibiotic for frontal sinusitis and sinusitis

Antibiotics for combined inflammation in the form of frontal sinusitis and sinusitis are prescribed taking into account the resistance of the pathogen to antibiotic therapy. Such an inflammatory process is considered a rather complex disease, so self-medication should never be done. For successful treatment of frontal sinusitis and sinusitis with antibiotics, it is necessary to adhere to the following rules:

• take antibiotics only as prescribed by your doctor;
• If you have previously taken any medications, you should definitely tell your doctor about this;
• you cannot make any adjustments to the antibiotic therapy regimen;
• If you accidentally miss a pill, do not take a double dose, just take the medicine as soon as possible;
• It is better to wash down the antibiotic with warm water, about 200 ml;
• drinking alcoholic beverages during antibiotic therapy is prohibited;
• It is advisable to include fermented milk products in your diet.

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Antibiotics for frontal sinusitis in adults

Since frontal sinusitis is an infectious process, antibiotics are considered the main medications for frontal sinusitis. They are chosen according to the following principles:

• if the pathogenic microorganism that causes frontal sinusitis is not identified, then it is necessary to prescribe an antibiotic with the broadest possible spectrum of activity;
• At the initial stage of treatment, the maximum effective amount of the drug is prescribed - it is preferable to use the antibiotic in the form of injections (after the acute symptoms have been relieved, you can switch to the tablet form of antibiotics);
• the duration of antibiotic therapy for frontal sinusitis in adults is approximately one and a half to two weeks, even in cases where the symptoms of the disease have ceased after a few days;
• the dose and frequency of taking antibiotics for frontal sinusitis is determined by the doctor individually in each specific case;
• Along with antibiotics, adjuvant therapy drugs must be prescribed - these are medications that relieve pain, lower temperature, and reduce the intensity of nasal discharge;
• If the antibiotic does not show a positive effect within 3-4 days after the start of treatment, it should be replaced with another one, taking into account the results of bacterial culture.

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Antibiotics for frontal sinusitis in children

In case of frontal sinusitis in children, taking antibiotics is mandatory and very important, since the inflammatory process can spread to the periosteum, bones and further to the brain. To avoid such complications, it is necessary to prescribe antibiotics to the child as early as possible.

Antibiotics are prescribed depending on the pathogen and the stage of the inflammatory process. At the same time, it is necessary to closely monitor the child's well-being, since an allergic reaction to the drug may develop during the first day of antibiotic therapy. If this happens, you should immediately give the child an antihistamine and stop taking the antimicrobial agent, notifying the attending pediatrician.

As a rule, the correct prescription of antibiotics for frontal sinusitis in children leads to a visible improvement in the condition already on the second or third day from the moment of the first administration of the drug. If the improvement is insignificant, or there is none at all, or even worse - the condition begins to deteriorate (the temperature persists, the nasal passages are blocked, pus is released), then the attending physician should replace the drug with another, with a stronger effect.

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Release form

The use of a competent comprehensive approach to the treatment of frontal sinusitis allows the patient to avoid surgery to open and drain the frontal sinus. Injection of an antibiotic solution into the frontal sinus is practiced relatively rarely and only in the presence of serious indications, since this procedure is considered quite traumatic.

Such forms of antibiotics as sprays and aerosols for intranasal (intracavitary) use are successful. The active component of such products is often aminoglycoside antibiotics - for example, Polydex or Isofra.

At the initial stages of antibiotic therapy, it is preferable to use injections of antibiotic solutions - these can be intramuscular or intravenous injections.

In case of mild frontal sinusitis, as well as after the elimination of acute symptoms of the disease, it is possible to take antibiotics in the form of tablets or capsules.

Names

The use of antibiotics for frontal sinusitis varies: drugs can be prescribed depending on the type and activity of the pathogen.

• Macrolide antibiotics – Azithromycin, Erythromycin, etc. Such medications affect the fact that unfavorable conditions are created in the body for the growth and development of bacteria that caused frontal sinusitis. The use of macrolides is especially recommended in cases of chronic frontal sinusitis, or when there is no possibility of identifying the pathogen.
• Penicillin antibiotics – Amoxicillin, Augmentin, etc. Such medications are considered relatively narrowly targeted, so they are prescribed only when the type of pathogen causing frontal sinusitis is precisely known.
• Cephalosporin antibiotics – Cefazolin, Cefecol, etc. Such drugs are similar to penicillins, but have an extended spectrum of antibacterial activity. Cephalosporins are prescribed when treatment of frontal sinusitis with other antibiotics has been found to be ineffective.
• Tetracycline antibiotics are prescribed mainly externally, or in cases where the patient has an intolerance to penicillins.

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Pharmacodynamics

It will be convenient to consider the pharmacodynamic and kinetic properties of antibiotics for frontal sinusitis using the example of the injection solution Cefazolin and the tablet drug Sumamed.

• Cefazolin is one of the most active antibacterial drugs. It has a detrimental effect on staphylococci, streptococci, corynebacteria, escherichia, shigella, klebsiella, proteus, enterobacteria, etc., but is powerless against rickettsia, viruses, fungi and protozoa. Cefazolin has an inhibitory effect on the construction of the cell wall of the pathogenic microorganism.
• Sumamed is an azalide, representing a relatively new subgroup of macrolides. At a certain concentration in tissues, it demonstrates bactericidal action. Sumamed affects gram-positive coccal flora, gram-negative microbes, and several types of anaerobes. Sumamed is powerless against gram-positive microbes that exhibit resistance to erythromycin.

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Pharmacokinetics

• After intramuscular injection, the active component of Cefazolin is immediately absorbed. The maximum level in the blood is observed within 60 minutes, remaining in a therapeutic concentration from eight to twelve hours. Excretion occurs through the urinary system (at least 90%). Cefazolin passes through the placenta, is determined in mother's milk. It freely enters the synovial fluid, into the joint cavities.

Intravenous injection allows for a higher concentration of the antibiotic in the blood, but the drug is eliminated more quickly.

• Sumamed tablets are perfectly absorbed from the digestive system: the active component is resistant to the influence of acidic environments. If the patient takes 0.5 g of the drug, the maximum concentration in the serum is observed within 2.5-3 hours. The biological availability of Sumamed is estimated at 37%.

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Dosing and administration

• Cefazolin can be used as intramuscular and intravenous injections or drip infusions. The average daily volume of the antibiotic for frontal sinusitis in adult patients is from 0.25 to 1 g, with an administration frequency of 3-4 times. The maximum daily amount of Cefazolin is 6 g. The duration of therapy is determined by the doctor.
• Sumamed tablets for frontal sinusitis are taken by adult patients in the amount of 0.5 g once a day for three days. Accordingly, the course dose of the drug is 1.5 g.

You should not self-medicate: frontal sinusitis can only be treated by a doctor, based on the results of diagnostics and the individual characteristics of the patient.

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Use antibiotics for frontitis during pregnancy

During pregnancy, treatment with Cefazolin is allowed, but only if there are strict indications.

Sumamed in tablets is not used to treat pregnant women.

Both drugs can be prescribed during lactation, but breastfeeding is stopped during treatment.

Contraindications

The unambiguous contraindications to prescribing antibiotics for frontal sinusitis are the period of pregnancy and individual reaction to the medication. In other situations, you can choose an antibiotic that will not be contraindicated in one case or another.

Relative contraindications to antibiotic treatment for frontal sinusitis may include:

• impaired liver function;
• childhood;
• impaired kidney function.

If the patient has relative contraindications, then the doctor selects the most optimal drug in a particular case.

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Side effects antibiotics for frontitis

Absolutely all antibiotics, including those prescribed for frontal sinusitis, have certain side effects. We present you with a list of the most common undesirable symptoms.

• Fungal infections of the skin or mucous membranes.
• Inflammation in the digestive tract, diarrhea, abdominal pain.
• Changes in the blood – leukopenia, eosinophilia.
• Loss of appetite.
• Allergy.
• Headaches, dizziness, taste changes, sensory disturbances, sleep disturbances, myasthenia, psychomotor disorders.
• Transient visual impairment.
• Tachycardia, changes in blood pressure.
• Difficulty breathing, nosebleeds.
• Hepatitis, cholestasis.
• Pain in muscles, back, joints.
• Feeling tired, fever.

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Overdose

Taking an overdose of antibiotics for sinusitis may be accompanied by increased side effects. The most common symptoms are nausea, transient hearing loss, vomiting, and diarrhea.

Treatment measures in case of overdose are symptomatic.

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Interactions with other drugs

• Cefazolin is not used simultaneously with anticoagulant drugs and diuretics.

Cefazolin and aminoglycosides should not be mixed in one injection.

• It is not advisable to take Sumamed simultaneously with antacid drugs, digoxin, medications based on ergot alkaloids, or cyclosporine.

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Storage conditions

Cefazolin is stored at room temperature, in places difficult for children to reach. It is recommended to locate storage areas for medications away from heating devices and sunlight.

Sumamed in tablets or capsules is also stored at normal room temperature, up to +25°C.

If you use other antibiotics for sinusitis, you can find out more about the rules for storing the drug from the attached instructions.

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Shelf life

Cefazolin in glass vials can be stored for up to 24 months, provided that appropriate conditions are met.

Sumamed in the form of tablets or capsules can be stored for up to 3 years.

Information about the expiration date for other antibiotics is written on the packaging or in the instructions for the specific drug.

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The best antibiotic for frontal sinusitis

Many people consider tablets to be the most convenient form of antibiotic for frontal sinusitis, so we will try to choose the most optimal and effective drug in this dosage form:

• Macropen is a popular representative of macrolide drugs, with the active component midecamycin. Macropen inhibits the development of pneumococci, hemophilic bacilli. The recommended intake of tablets is three times a day after meals, for two weeks.
• Augmentin is the most prominent representative of polysynthetic penicillin drugs, with a broad spectrum of activity. The course of therapy with Augmentin is not recommended to continue longer than 2 weeks, as this can lead to the development of side symptoms, such as dyspepsia, imbalance of microflora.
• Sumamed is one of the modern antibacterial agents from the macrolide group. The tablets are taken only once a day, between meals, for five days.
• Flemoxin Solutab is a penicillin drug with a relatively small number of side effects (provided that the dosage is strictly followed).
• Amoxiclav is an antibiotic that is often used for various respiratory infections in adult patients. Amoxiclav belongs to the class of semi-synthetic penicillin drugs.
• Zitrolide is a macrolide drug with a relatively strong and pronounced antibacterial effect. It is enough to take the medication once a day, between meals.

At the initial stage of the disease, antibiotics are often prescribed by injection: the drug solution acts faster, as it has greater bioavailability:

• Ceftriaxone is a third-generation cephalosporin antibiotic. The drug is effective in acute frontal sinusitis. It is available in ampoules as a lyophilisate for making a solution. Ceftriaxone can be administered intravenously or intramuscularly.
• Cefazolin is a semi-synthetic cephalosporin with strong antibacterial activity. It is well accepted by the body, but in some cases it can still cause allergies and dysbacteriosis.

Treatment of frontal sinusitis without antibiotics

The use of antibiotics for the treatment of frontal sinusitis is mandatory - but only in the case of bacterial etiology of the disease. In case of allergic nature of frontal sinusitis, antihistamines prescribed against the background of anti-inflammatory, antipyretic and immunostimulating treatment will be effective. Complex prescription of medications will help to relieve pain in a short time, eliminate swelling of the mucous membrane of the nasal sinuses, strengthen the body and tune it to fight the infection.

In case of viral frontitis, specific drugs – interferons – will come to the rescue. These are drugs that contain human interferon α-2b – this substance activates the immune response in otolaryngological viral infections. The most popular medications in this area are:

• Grippferon;
• Grippferon with loratidine (with an antiallergic component);
• Laferobion.

Throughout the treatment of frontal sinusitis, it is necessary to control the state of the intestinal microflora. To prevent dysbacteriosis, it is recommended to take an antifungal drug, for example, Fluconazole. If time has been lost and dysbacteriosis has already developed, it is important to start taking additional probiotic and prebiotic drugs as soon as possible.

Antibiotics for microbial frontal sinusitis are an important and mandatory stage in the treatment of the disease. However, it should be taken into account that the drug should be selected and prescribed only by a doctor. Chaotic and illiterate use of antibiotics can provoke a significant worsening of the patient's condition, as well as lead to the emergence of resistance of the causative bacteria to the medication taken.