Because penetration of antibiotics inside the sinus is poor, an extended treatment program is often necessary. Also, oral antibiotics do not penetrate well into bone and bacteria can be located inside or near bone. Typically a minimum of three weeks or more of oral antibiotic treatment is necessary, sometimes 4-6 weeks of treatment may be appropriate. Some physicians may only treat patients with oral antibiotics for a week or ten days and as a result, offer patients a temporary cure. We recommend an extended course of oral antibiotics before a patient has been judged to fail oral treatment.
Intravenous antibiotics are highly successful when orals have truly failed.
Oral antibiotics may be absorbed in the intestinal tract and may not adequately profuse diseased tissue and bony material in the sinuses. Therefore, some chronic infection patients may not experience resolution of their infection through oral antibiotics alone. Surgeries are effective in restoring drainage and natural aeration to the sinuses. Such procedures are not designed to cure deep set infections or bony substructure infections. Intravenous antibiotics allow for greater profusion of the sinus cavities and underlying structures.