Dr. Ramakrishnan recently attended Rhinoworld 2019, the international meeting of the American Rhinologic Society (ARS), International Rhinologic Society (IRS), and International Society on Inflammation and Allergy of the Nose (ISIAN). At this conference, Dr. Ramakrishnan learned about the latest advancements in the diagnosis and treatment of diseases of the nose and sinuses in order to benefit the good citizens of Wake County. Dr. Ramakrishnan created these blogs to provide the most recent research and useful information to those we serve.

Update on Treatment of Acute Sinusitis

Acute sinusitis is one of the most common issues people go the doctor for, and 95% of acute sinusitis infections are caused by viruses (common cold).

Antibiotics do not work for viruses. However, a recent study showed that about 70% of people that go to the doctor for acute sinusitis are treated with an antibiotic. Unnecessary antibiotic use has been definitively shown to lead to the formation of antibiotic-resistant bacteria.

It is currently thought that over the next 10-20 years, infections caused by antibiotic-resistant bacteria will cause over 10 million deaths worldwide.

Unnecessary antibiotic use can also cause long-lasting damage to an individual’s microbiome, which can lead to other diseases, such as other types of infections (C. Diff colitis, yeast infection), allergies/asthma, gastrointestinal diseases, and autoimmune disease.

Another study showed that a nasal steroid spray (like Flonase) worked better to treat acute sinusitis compared to amoxicillin and that a placebo (sugar pill) worked just as well as amoxicillin.

The current recommendation for treatment of acute sinusitis is a nasal steroid spray (like Flonase) and simply treating the symptoms with OTC medicines.

For example, acetaminophen or ibuprofen for pain/sore throat, decongestants for congestion/pressure, and nasal saline for nasal congestion/drainage

Rest and hydration help, too. Treatment with antibiotics should be considered in the small number of cases of acute sinusitis where there is high fever, severe pain on one side of the face, and a lot of discolored or bad-smelling nasal drainage.

We all need to work together to be good antibiotic stewards!


For more information, you can review this interesting article from the Centers for Disease Control:

Information for Patients: Antibiotic Prescribing and Use in Doctors’ Offices 


Raleigh Capitol Ear, Nose, and Throat is the area's premiere physician-owned ENT practice with seven convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. For more information or to schedule an appointment, contact us.