Sinus Infection

     All parents are aware of the problems that have come from using too many antibiotics and we all are trying to give as few of these medications as possible to our kids. Ear infections used to be the most common reason children were given antibiotics, however, doctors now realize that ear infections often cure themselves without needing antibiotics. Another common reason for giving antibiotics was sinus infection. Now the American Academy of Pediatrics has come out with new guidelines for diagnosing and treating sinus infections in children between the ages of 1 and 18 years of age. By following these guidelines, we should be able to further decrease the use of antibiotics.

     Colds and upper respiratory infections are the most common infections that affect children in general, but most of these infections are caused by viruses that are not killed by antibiotics.  No treatment is necessary for the child to recover.  At the beginning of a cold, the child’s nose has a clear discharge that gradually gets thicker over a matter of days. As this happens, the child’s cough gets worse. Cough and congestion that comes with a normal cold can last up to two weeks, but the child usually feels better after a few days and the symptoms gradually improve. The first new guideline states that if thick nasal congestion and cough last for more than 10 days without any improvement at all, the child could possibly have a sinus infection

     The next new guideline states that X-rays and CAT scans are not recommended to make the diagnosis of sinus infection. Anytime a child has a cold, these X-rays can look positive even in a child who doesn’t have a sinus infection, so these tests aren’t helpful.

     The last new guideline is that, if the parent or the doctor thinks the child may have a sinus infection, they should wait three more days before starting antibiotics to see if there is any improvement. If the child’s symptoms still don’t improve during that extra three-day wait, antibiotics should be started.

     Antibiotics are important medications when they are used properly. Bacterial resistance to antibiotics due to over-use is increasing every year.  It is up to all of us to use antibiotics only when they are necessary and constantly updating the guidelines for the use of antibiotics is one way for that to happen.