Other options include cephalosporins such as cefpodoxime proxetil (Vantin) and cefuroxime (Ceftin). In patients allergic to beta-lactams, trimethoprim-sulfamethoxazole (Bactrim), clarithromycin (Biaxin), and azithromycin (Zithromax) may be prescribed but might not be adequate coverage for H. influenzae or resistant S. pneumoniae . 16 Penicillin, erythromycin (Suprax), and first-generation cephalosporins such as cephalexin (Keflex, Keftab) are not recommended for treating acute sinusitis because of inadequate antimicrobial coverage of the major organisms.
The sinus specialist will prescribe different medications (antibiotics, decongestants, nasal steroid sprays, antihistamines) and procedures ( nasal and sinus saline irrigation ) for treating acute sinusitis. N asal steroid sprays with or without antihistamine sprays are the primary foundational medical therapy for nasal and sinus problems. At least for those with chronic or recurrent problems. In most cases medical therapy consists of a nasal steroid spray or inhaler. In those with polyps (or hypertrophic disease) a topical medicated rinse may be needed.