Antibiotics have very less penetration in bony sinuses inflamed over long periods and coupled with resistant bacterial biofilms, antibiotics have a very limited role to play in management of chronic sinusitis. Surgical disease removal followed by nasal saline and medicated washes are the most effective method for removing inflammation and infection. Further, frequent antibiotic courses lead to antibiotic resistance not just in the patient but also in the community and can have potential adverse effects on immunity.