Since most cases of sinusitis are caused by a virus, your doctor or pharmacist may only recommend oral (e.g., phenylephrine*, pseudoephedrine) or topical (e.g., oxymetazoline, xylometazoline) decongestants, saline nasal sprays or rinses, and pain medications such as acetaminophen or ibuprofen, to help relieve symptoms. If you have heart disease, high blood pressure, thyroid disease, diabetes, glaucoma, or prostate problems, or if you are pregnant or breast-feeding, talk to your doctor before taking these medications.
Decongestant sprays should not be used for more than 3 days in a row or they can cause "rebound congestion." Steam inhalation and cool mist humidifiers may also help. It may help to add eucalyptus and menthol-based decongestants to the hot water. Although they are safe for adults, decongestants are not recommended for young children.
If these measures do not improve symptoms after 10 days, or if your symptoms are severe, then your doctor may prescribe antibiotics. Antibiotics are not usually prescribed because acute sinusitis is usually viral in nature. The typical duration of antibiotic treatment is 5 to 7 days for adults and 10 to 14 days for children. If the infection becomes chronic (lasting more than 3 months) the antibiotic therapy may be used for longer, usually up to 6 weeks.
It's important that you take all of the antibiotic medication as prescribed, even after symptoms have disappeared. Otherwise the bacteria could return in a form that's resistant to the antibiotic.
For chronic sinusitis, your doctor may prescribe a corticosteroid (nasal spray or tablets) with or without antibiotics. Your doctor may also suggest saline rinses and decongestants to relieve your symptoms. Antihistamines may be suggested if allergies are contributing to chronic sinusitis. Surgery may be an option for people with chronic sinusitis that is not responding to treatment.
There's no guaranteed way to prevent all causes of sinusitis, but you can reduce your risk of viral infections by washing your hands frequently and properly, avoiding tobacco smoke, and reducing your exposure to things you are allergic to.