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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17555
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I picked up a virus a week before Christmas. The doctor gave

Customer Question

I picked up a virus a week before Christmas. The doctor gave me some antibiotics which seemd to work to a degree but this virus has come back with a vengeance. My sinusus are blocked and having trouble in breathing. I'm also finding it hard to drink as with my sinusus blocked if water goes into my mouth I can hardly swallow and really not able to swallow now. I have no temperature but a hacking cough which excuserthe expression sounds like a donkey making a noise. It is choking when I cough. I hae tried cough mixtures paracatemol and even honey but no success. It is really wearing me out now. I have very little energy and worried that I can't drink at times. I did drink tea this morning but tried to drink water and can't. Mind you I don't normally drink water anyhow as I don't like it. Any advice on this would be appreciated. By the way I'm 76 and on medication for blood pressure and blood tinning tablets as well as vitmin d tablets. Thank you
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
It will help if you could provide some further information:
Which antibiotic was prescribed?
When did you complete the course of antibiotics?
What length of time elapsed before the symptoms got worse?

Customer: replied 2 years ago.

HI I can't remember 2what the anti-biotics was called. I got them on the 23rd December and completed te five day course but never really got rid of it. I couldn't go out over the Christmas as didn't want to infect others. I eventually went out on December 30th., but still the sinusus were bad but seems to be worse over the last couple of days.


 

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information.

There are several issues to consider in this situation.

First, it is most likely that you have developed a secondary bacterial infection on top of the original viral infection. There are no antibiotics that will help with a viral infection, so the facts that your doctor prescribed an antibiotic and that it helped (albeit only partly) would support that there was a secondary bacterial infection. For example, it is possible for a person to first have a viral infection that then leads to a bacterial infection of the sinuses, and with your sinus symptoms, this would be the most likely in your case.

With a bacterial sinus infection, there are a number of antibiotics that are considered first-line antibiotics, but there is no antibiotic that is effective 100% of the time. If a person only has a partial response to the initial antibiotic, then it would be appropriate to choose a different antibiotic that works via a different mechanism, since it will attack the germs in a different way. There also are some antibiotics that are stronger, in that they are oriented towards more resistant germs. These stronger antibiotics are usually not used as first-line antibiotics because broad use of these antibiotics will promote resistance to these antibiotics as well, so they are usually kept in reserve until a patient has demonstrated that a stronger antibiotic is necessary.

Since you don't recall which antibiotic was prescribed, it is difficult to discuss which antibiotic would commonly be used as the next choice, but you would need to get a prescription for whichever antibiotic is used anyway, and your doctor will know which antibiotic was previously used.

There are a couple of home interventions that can be done to try to help ease symptoms. The cough medicines that are most likely to help ease the sinus blockage would be any that contain a decongestant. However, decongestants can potentially raise blood pressure, particularly in someone with a history of high blood pressure. The potential for affecting blood pressure is not such that it should never be used, but we would rather avoid them if we can, and if needed, there should be monitoring of the blood pressure.

Another intervention that can be used is saline (salt water) for relief of the congestion and sinus blockage. This is available as saline nose sprays, but when I have these symptoms, I find it more effective to use a larger volume of saline, such as irrigation of the nose and sinuses with a NetiPot.

Since you find that you can tolerate tea, it is fine to use tea for fluids. If concerned about maintaining hydration, it would be better to drink a decaffeinated tea, as the caffeine has a diuretic effect and will not help hydration.

Therefore, at this point, it would be reasonable to use the home interventions noted above, but it also would be appropriate to contact your doctor for consideration of a different or stronger antibiotic.

If you have any further questions or need clarification, please let me know.


Expert:  Dr. D. Love replied 2 years ago.

I do not see that you have received or reviewed the answer that I provided above. Sometimes, the notification system fails, so I am placing another post to prompt the system to send another notification. My answer is as above. If you have any further questions, please let me know.

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