Sinus infection or a cold? When antibiotics help

Your sinuses are small air pockets in your face. When they swell and fill with fluid, you can get:

• A runny or stuffy nose
• Pain or pressure in your face
• Headache
• Mucus dripping down your throat
• Sore throat
• Cough
• Bad breath

A cold is caused by a virus. It most often gets worse for 2 to 3 days, then gets better. Most colds last less than a week.

A cold can lead to a sinus infection. Most sinus infections are caused by viruses too, and they get better on their own.

Antibiotics kill bacteria. They do not work on viruses. Most sinus infections are caused by viruses, so antibiotics will not help them.

When you do not need antibiotics, they can still cause harm. Side effects range from a rash to a bad allergic reaction or a serious type of diarrhea.

A doctor may think of bacteria when:

• Symptoms last more than 10 days and are not getting better
• A cold starts to get better, then gets worse again, with new fever, more mucus or more cough
• You have a high fever (102°F or higher) with thick, colored mucus or face pain for 3 to 4 days in a row. With a high fever, see a doctor in person.

Even then, a doctor may suggest you wait 2 to 3 days to see if you get better on your own. This is called watchful waiting. If you do not get better, the doctor may then prescribe an antibiotic.

• Put a warm, damp cloth over your nose and forehead.
• Use a salt water (saline) nose spray.
• Breathe in steam from a hot shower or a bowl of hot water.
• Ask a doctor or pharmacist which store-bought medicines can help.

Decongestant nose sprays can help for a short time. Do not use them for more than 3 days. Using them longer can make your stuffy nose come back or get worse.

For children: do not give store-bought cough and cold medicine to a child under 4 unless a doctor tells you to. Never give aspirin to a child.

• Very bad headache or face pain
• Symptoms that get worse after getting better
• Symptoms that last more than 10 days and are not getting better
• Fever for more than 3 to 4 days
• Several sinus infections in the past year

Get emergency care right away for swelling or redness around an eye, a change in your vision, trouble moving an eye, a very bad headache with a stiff neck, confusion, or swelling over your forehead.

If you are in Virginia or West Virginia, you can start a visit online at any time. Our sinus infection visit is for adults and for children 4 and older (with a parent or legal guardian) whose symptoms have lasted 10 days or more without getting better, or got better and then worse again.

You answer a few questions on your phone or computer. There is no video call. A board-certified physician reviews your answers. The doctor may prescribe an antibiotic, or may suggest care at home if an antibiotic is not likely to help. If you need to be seen in person, the doctor will tell you.

This visit is not for people with a weakened immune system, a high fever with feeling very sick, or numbness or weakness in the face. They should be seen in person.

For a newer cold or sinus symptoms with no high fever, our cold, flu and sinus visit is the better fit.

Visits start at $59. You see the price before you pay, and you do not need insurance.