For acute sinusitis, usually your doctor will arrive at a diagnosis based on history (e.g., a recent cold), symptoms, and an examination.
Computed tomography (CT) scans and endoscopy (a small flexible tube is inserted into the nose to view the nasal passages and sinuses) may be done if you have sinusitis complications or chronic sinusitis.
When sinusitis is chronic or recurrent, your doctor may suggest allergy testing to see if allergies are causing sinusitis symptoms.
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.
Decongestant sprays should not be used for more than 3 to 5 days in a row or they will cause "rebound congestion." The safety and effectiveness of using decongestants for children less than 12 years of age has not been established and is not recommended by most doctors.
Your doctor may also prescribe a corticosteroid nasal spray.
If these measures do not improve symptoms after 7 days (for adults) or 10 to 14 days (for children), or if your symptoms are severe, then your doctor may prescribe antibiotics. However, only about 30% of people with sinusitis will need antibiotics. The typical duration of antibiotic treatment is for 5 to 10 days. If symptoms do not improve after 3 days of treatment, contact your doctor as you may need to change to another antibiotic.
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. 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.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.