The best approach is to use antibiotics conservatively. A program in Finland, for example, nearly halved the incidence of erythromycin-resistant bacteria by limiting the use of this and similar antibiotics. Physicians in Scandinavian countries, in order to prevent overuse of antibiotics, recommend prescribing penicillin for only two days and only for selected cases of acute sinusitis. In general, if a patient with acute sinusitis lives in a region where resistance to standard antibiotics is still low, it is probably safe to start with a less expensive antibiotic and switch over to a more powerful drug if the infection does not clear up. The most common side effect for nearly all antibiotics is gastrointestinal distress.
Antibiotics also double the risk for vaginal infections in women.
Patients should inform the physician of all medications they are taking and of any drug allergies. Antibiotics are usually prescribed for 7 to 10 days. If there is no improvement after two weeks of treatment, x-rays should be taken and a stronger antibiotic used. Emergency Treatment Patients who show signs that infection has spread beyond the nasal sinuses into the bone, brain, or other parts of the skull require emergency care. High dose antibiotics are administered intravenously, and emergency surgery is almost always necessary in such cases.