Symptoms of sinusitis in children
At the beginning of the development of sinusitis, its symptoms in children are similar to a cold, which is why treatment is not always started in a timely manner. In the absence of therapy, the pathology turns into a purulent form, which manifests itself violently. Symptoms of sinusitis in children in this case are as follows:
- elevated temperature, at which severe chills are observed,
- lethargy,
- tearfulness – present in young children who cannot yet accurately explain their condition and express dissatisfaction with what is happening through crying,
- headache, which is significantly worse when walking, sneezing and bending forward. Children tend to lie down as often as possible, since in this position the pain syndrome weakens,
- nasal congestion leading to nasal twang,
- refusal to eat due to pain in the upper teeth - any pressure on the teeth of the upper jaw causes pain, as simultaneous irritation of the inflamed sinus and nerves of the tooth occurs,
- purulent and mucous discharge from the nasal passages - they lead to severe irritation of the skin of the nasolabial triangle, causing it to become inflamed. If, due to swelling of the tissues, the discharge of the sinus contents stops, then the baby suddenly stops any flow from the nose,
- partial or complete loss of smell,
- cough - appears in every second patient and is caused by constant irritation of the mucous membrane with secretions from the diseased sinus, which drains to the back wall of the pharynx,
- pain when pressing on areas of the inflamed sinus or corner of the eye - even light pressure leads to a sharp increase in pain,
- Swelling of the cheek and lower eyelid from the side of the affected sinus - the bone septa in children are thin, and cases are not uncommon when the inflammatory process spreads to the orbit and upper jaw, causing their pronounced swelling.
The doctor will make the correct diagnosis. It is not possible to determine the disease at home.
Types of antibiotics for sinusitis
What antibiotics to take for sinusitis is determined by a specialist based on the results of a smear with bacterial culture. If analysis is not possible, broad-spectrum agents are used. The intensity of the pathological process affects how strong the medicine will be prescribed to the child. Antibiotics for sinusitis and sinusitis for children, due to side effects, are prescribed in extreme cases. Drugs are divided into 4 main groups.
- Penicillin drugs. They cause less harm to the body and are effective in 80% of cases in the initial form of the disease. The main representatives of the group are amoxicillin, ampicillin and amoxiclav. The dosage of the medicine should correspond to the age of the patient.
- Macrolides. Antibiotics are stronger than penicillin and have more contraindications and side effects. Drugs in this group: azithromycin, roxithromycin, sumamed and clarithromycin.
- Cephalosporin drugs. Drugs are prescribed for advanced sinusitis, as well as if treatment with medicinal compounds from the two previous groups has already been carried out less than 3 months ago. Medicines are considered quite severe and are not used often. Cedex, ceftriaxone, cefuroxime can be prescribed.
- Agents from the fluoroquinolone group. The drugs are prescribed in extreme cases, when other treatment does not produce results, and the cause of sinusitis is Pseudomonas aeruginosa. The minimum age from which the composition can be taken is 5 years. Prescribed: lomefloxacin or ciprofloxacin.
Antibiotics are used in the acute form of the disease, when the inflammatory process develops rapidly and the patient’s condition suffers greatly. In the chronic course of the pathology, antibiotics should not be used, as this can cause the formation of drug-resistant sinusitis pathogens. As a result, during an exacerbation of the disease, it will not be possible to select a sufficiently effective drug.
Types of antibacterial drugs prescribed for children with sinusitis
For a bacterial infection of the paranasal sinuses, using antibiotics is not only possible, but necessary. Of course, you shouldn’t decide which drug is right for your baby on your own. It is best to visit a pediatrician or otolaryngologist, who will prescribe treatment taking into account what symptoms the baby has and what disease was ultimately diagnosed.
Penicillins
The choice of drug usually depends on several factors. Firstly: we are talking about the stage of the disease; secondly: on the age of the children who require treatment. In the initial form of sinusitis (sinusitis), experts prescribe penicillin antibiotics, which have a wide spectrum of action, act very gently on the child’s body and cause a minimal number of side effects. The following medications are often used:
- Amoxiclav;
- Ampicillin;
- Amoxicillin.
If such antibiotics could not defeat the infection, then it is quite possible that they are not suitable for the child according to his individual parameters or the disease has already moved to the next stage of development. The development of sinusitis occurs quite quickly and it is not always possible to keep track of what stage the disease is currently at. When, after taking medications of this group, no changes occur and even moreover, the child begins to feel worse, this should alert parents and cause them to consult a doctor again.
Macrolides
When penicillins have not had the desired effect or the patient has recently taken broad-spectrum antibacterial agents, the doctor turns to another group of antibiotics - macrolides. The list of such drugs includes:
- Sumamed;
- Roxithromycin;
- Clarithromycin;
- Azithromycin.
The medications are prescribed to children strictly according to the current instructions and under the supervision of their parents.
Cephalosporins
If the pathogen is insensitive to macrolides, it will be necessary to use other drugs - a group of cephalosporins. These drugs are mainly prescribed to adults, but if the child’s condition is very serious and other medications have not had the desired effect, then it is worth turning to these formulations:
- Cefriaxon;
- Cefuroxime;
- Tsedex.
Fluoroquinols
It is extremely rare that fluoroquinolone antibiotics that are particularly complex in composition and “difficult” for children are used.
According to doctors, these are not at all children’s medicines, which can only be prescribed to children after 5 years of age. The action of antibiotics is designed to destroy the causative agent of the disease - Pseudomonas aeruginosa, however, while taking medications, you can encounter a large number of side effects.
This group of drugs includes:
- Ciprofloxacin;
- Lomefloxacin.
The use of drugs of a particular group directly depends on the presence of indications for prescription, as well as taking into account contraindications.
Taking the last group of medications is an extreme measure of influence on the patient’s body, therefore, you should first use all possible options with a milder effect and prevent the disease from moving into a severe phase.
Drops and sprays for treatment
Antibiotics for children with sinusitis and sinusitis are prescribed in the form of drops or sprays for local use. They have a local effect and do not have severe side effects. When using them, the risk of developing dysbacteriosis, oral thrush and allergies is minimal. Also, the maximum concentration of the drug directly in the area of inflammation increases the speed of recovery.
The maximum surge in incidence in children is observed at the age of 7-10 years. In pediatric practice, 3 types of drugs are used, which are characterized by the fastest possible action and are prescribed to children for sinusitis.
- Polydex – release form – spray. The medicine contains the antibiotic neomycin. The drug has strong anti-inflammatory and antibacterial effects. For children, the product can be used from the age of 2.5 years.
- Isofra - release form - spray or drops. A drug containing the antibiotic framycetin, which has an intense effect. The use of the product is allowed from 18 months, and in exceptional cases - from one year. Treatment of sinusitis in children with the drug is possible only if the nasal septum is intact.
- Bioparox is a release form - an aerosol, which has nozzles for nasal spraying and treatment of the pharynx. The antibiotic included in the drug is fusafungine. The drug is prescribed for treatment from 2.5 years. There are quite a lot of restrictions on taking medications .
Drops are used mainly in patients over 24 months of age. In children under 2 years of age, sinusitis does not often develop due to the structural features of the maxillary sinuses. At an older age, when a problem appears, the use of most necessary medications is permitted.
Main groups of antibiotics
In order for the treatment of sinusitis in children with antibiotics to give a positive result, various groups of drugs are used. The choice of drug depends on the severity and duration of the disease.
Penicillins
This group is used in the initial stage of sinusitis, when the disease is not associated with complications. These medications are well tolerated by children, occasionally provoke allergies, and do not have a toxic effect on the child’s body. The drugs are prescribed to children in the form of tablets. The most common are the following:
- Ampicillin is a semi-synthetic broad-spectrum antibiotic that exhibits a bactericidal effect due to the destruction of the synthesis of the cell wall of microorganisms.
- Augmentin - consists of clavulanic acid. The medicine is used to treat sinusitis; if penicillin is individually intolerable, the medicine cannot be used for children.
- Amoxicillin is effective against bacteria that cannot kill penicillinase. You should not consume the medicine for a long time, because... bacteria become accustomed to the drug. If after 2 days of using Amoxicillin there is no improvement, you should consult a doctor and change the drug.
These medications are quite effective. However, patients with renal failure and bronchial asthma consume with caution. Children prone to allergies take the medicine along with antihistamines.
Cephalosporins
This group is prescribed for complex sinusitis and the ineffectiveness of other medications. There are the following types of drugs that can eliminate the pathogen:
- Ceftriaxone is a third-generation medicine; it must be used after a doctor’s prescription, because can cause side effects and complications. In pediatrics, it is used with caution, since incorrect use can destroy the healthy flora of the susceptible small intestine.
- Cefuroxime is a second generation cephalosporin drug. It is a bactericidal antibiotic, highly active against gram-negative bacteria such as Escherichia coli, Shigella, Proteus, and Salmonella.
Macrolides
Macrolides are used in case of ineffectiveness of the penicillin group. The oldest drug in this series is Erythromycin, but today it is rarely prescribed due to the risk of superinfection. For sinusitis, doctors most often prescribe for children:
- Azithromycin - instantly penetrates into the blood from the gastrointestinal tract and at the same time quickly supplies substances to the inflamed area. It is effective against various bacteria that cause sinusitis. Contraindicated in children with liver disease.
- Clarithromycin is a semisynthetic antibiotic with a wide spectrum of effects. Under its influence, the action of bacterial protein synthesis in the body is destroyed.
These medications interfere with the development of bacterial cells. They are used for children with acute and chronic forms of sinusitis. Macrolides are a minimally toxic group with virtually no side effects.
Fluoroquinolones
These drugs are used in the treatment of children over 5 years of age in the presence of complications caused by Pseudomonas aeruginosa. Antibacterial drugs do not cause addiction in microorganisms, so they can be used for a long time (only after a doctor’s prescription).
- Lomefloxacin is a second generation bactericidal antimicrobial drug. It damages transcription and DNA replication of bacterial cells, and this leads to their destruction. Highly active against gonococci; intestinal, pseudomonas, hemophilus influenzae; meningococci.
- Tsifran is a broad-spectrum bactericidal and antibacterial. A combined medicine for the treatment of infections caused by aerobic and anaerobic microorganisms. Cifran is rarely prescribed to children, but it is possible to use 5-10 mg/kg per day, divided into 2 times.
Consume in the form of tablets after meals, 1 hour later, with plenty of water.
Complex drops
Complex drops are a medicine that contains several drugs for nasal use. The components and their ratio are determined by the doctor. Complex drops are made to order in pharmacies. Which antibiotic for sinusitis in children will be included in the product is decided largely based on the results of a smear, which is taken to determine the pathogenic microflora.
They resort to this treatment if other methods do not produce results for a long time. The storage time of complex drops is short - from 5 to 7 days. The most powerful antibiotic for sinusitis in children is used when using compound preparations.
When antibiotics are not required
Antibiotics for sinusitis are prescribed only if the cause of the disease is various bacteria. Incorrectly selected treatment contributes to the deterioration of the clinical picture and the emergence of a number of complications.
Antibiotics are not prescribed:
- For allergic sinusitis. The main task in the treatment of allergic frontal sinusitis is to stop contact with the main irritant and take antihistamines.
- For sinusitis caused by a viral infection. Antiviral drugs and nasal rinses are the main methods of treating the disease.
- For fungal sinusitis.
Many people suffering from inflammation of the paranasal sinuses try to cure themselves with antibiotics. This is a big mistake; the wrong type of drug may simply not have the desired effect on the causative agent of the disease. As a result, sinusitis becomes chronic, treatment takes a long time and the person suffers from many complications.
Causes of sinusitis in children
In children, the development of sinusitis is observed against the background of an advanced runny nose. The following reasons provoke inflammation:
- adenoids - they provoke a violation of the outflow of mucus and lead to its accumulation in the nasal sinuses, in which conditions favorable for pathogenic bacteria are created and inflammation develops,
- insufficient activity of the immune system,
- frequent colds that are treated poorly,
- congenital disorders in the structure of the nasal septum, due to which the correct discharge of mucus from the sinuses is changed,
- pathologies of the vessels of the nasal cavity, due to which the mucous membrane does not receive enough nutrients,
- long-term allergies
- traumatic injuries to the nasal passages and sinuses.
The chronic form of the disease occurs after acute sinusitis, which is not treated. Exacerbations of the disease occur regularly with the onset of the cold season. Early cessation of taking antimicrobial agents in children with acute sinusitis can also cause it to become chronic.
Anatomical features of the development of the maxillary sinus in children
The formation of the frontal sinuses continues until the age of 18-20. The structure of the skull in adults and children has serious differences. This is necessary for bone growth to occur.
The location of the maxillary sinuses in children under three years of age is higher than in adults. In infants, the maxillary sinuses are a narrow slit in which secretion cannot accumulate. This does not result in the development of sinusitis at an early age.
The size of the sinus increases as the skull grows. They begin to work in the same way as adults at the age of 16-17. By the age of 20, the sinuses are fully formed and begin to perform all functions:
- reduction in the weight of the skull,
- warming and purifying inhaled air,
- reducing the intensity of injury from blows to the face,
- ensuring individual voice characteristics,
- prevention of hypothermia of the nerve endings and roots of the teeth of the upper jaw.
Due to the fact that in children the maxillary sinuses are not sufficiently formed, they cannot function fully, and when allergens enter them, an inflammatory process often develops.
Due to the accessibility of the sinuses in children, if they seek help in a timely manner, taking local antibiotics in the form of drops and sprays is sufficient.
Whether it is possible to cure sinusitis in a child without antibiotics depends on the age of the patient and the cause of the inflammation. If therapy begins in a timely manner before the development of a purulent process, then in most cases it is possible to do without antibiotics.
Sinusitis: antibiotics
Antibiotics will help effectively get rid of the inflammatory process. The question immediately arises, what antibiotics to use to quickly get rid of sinusitis? When choosing the optimal drug, the doctor takes into account:
- symptoms of illness;
- severity of sinusitis;
- characteristics of the patient.
If sinusitis was caused by bacteria, then antibiotics are used to suppress the activity of pathogenic agents. When the disease is caused by fungal infections, the antibiotic fusafungine is usually prescribed. This is a unique drug with a wide spectrum of action. It effectively affects all bacterial and pathogenic microflora.
Antibiotics for sinusitis in children and adults are used topically in the form of drops and nasal sprays, as well as for general treatment in the form of tablets. They are prescribed intramuscularly and intravenously in the form of injections . This method is one of the main ones in the treatment of sinusitis.
The duration of taking an antibiotic for sinusitis always depends on the degree of development of the disease, general health and the type of antibiotic. If after taking the drug within 5 days the condition does not improve, it is necessary to change the medication. In the chronic form, you should pay attention to the previous antibiotic that was used for treatment. If it didn’t help much, then you need to use another one.
Since antibiotics are the most allergenic drugs in treatment, choosing them yourself is very dangerous. This should be done by the doctor after the appointment and diagnosis.
Main groups of drugs
Antibiotics for sinusitis are always selected by an ENT doctor . There are many types of antibiotics to treat sinusitis in adults and children. These include:
- penicillin and its analogues - in tablets and ampoules;
- cephalosparin drugs - in the form of tablets and powder for injection;
- group of macrolides - tablets and syrupy suspensions for children;
- sulfonamides (antiseptic substances);
- topical preparations - drops for instillation into the nose.
Now let's look at these groups of drugs in more detail to become familiar with the properties and effects of the most popular drugs in the treatment of sinusitis.
Diagnosis of sinusitis in children and treatment with antibiotics
The diagnosis is made not only on the basis of external examination and existing complaints. It is necessary to carry out tests to determine the pathogenic microflora and the degree of inflammation. For diagnostic purposes, a smear from the nasal cavity is performed with further bacteriological culture on a nutrient medium, as well as an X-ray or MRI (allowed for children under one year old). In children, preference is given to magnetic resonance imaging, which does not have a negative effect on the body.
After identifying the causative agent of the disease, antibiotics active against it are prescribed. More often, broad-spectrum drugs are prescribed to start therapy as quickly as possible.
What antibiotic is prescribed for sinusitis in children?
What antibiotic is prescribed for sinusitis in children? At the very beginning of the disease, penicillin drugs can be used:
- Amoxiclav . A broad-spectrum drug. Appointed from age 12. Average price – 353 rubles;
- Amoxicillin . Broad-spectrum antibiotic. The average price is 66 rubles.
In the absence of a therapeutic effect, antibiotics from the macrolide group are recommended:
- Summed . Bacteriostatic antibiotic. Allowed from 6 months of age. Average price – 528 rubles;
- Roxithromycin . Has a bacteriostatic effect. Allowed from 12 years of age. Average cost – 470 rubles;
- Azithromycin . Broad-spectrum antibiotic. Allowed from one year of age. The average price is 112 rubles.
In advanced forms of the disease, treatment with cephalosporins is carried out:
- Ceftriaxone . 3rd generation bactericidal drug. Angina is also treated with this drug. Allowed from the first days of life. Price – 407 rubles;
- Cefuroxime . An antibiotic is used for bacterial infections. Average price – 536 rubles;
- Tsedex . A drug with a bactericidal effect. Allowed from 6 months of age in the form of a suspension. The capsule form is allowed from 10 years of age. The average cost is 753 rubles.
The harm of self-medication
Self-medication only leads to a worsening of the child’s condition, since doses of antibiotics that are taken incorrectly only overload the body. This also significantly increases the risk of the emergence of bacteria resistant to major antibiotics, which seriously complicates therapy. Cases of overdose are not uncommon during self-medication.
How to cure sinusitis without antibiotics in a child is determined by the doctor. If he does not see such a possibility, then parents should not refuse antibiotic drugs.
Children with sinusitis are prescribed antibacterial therapy with local or general drugs, depending on the age and condition of the little patient. All doctor’s recommendations must be strictly followed, and the course of treatment cannot be interrupted prematurely.