Does your winter cold need antibiotics?

Seven's On Call with Dr. Jay Adlersberg
December 18, 2007 9:00:00 PM PST
This time of year, many of us suffer from the sniffles. But how do you know if it's something more serious?Seven's On Call with Dr. Jay Adlersberg.

More serious cases might be a sinus infection that may need antibiotics. But one report recently said patients did no better on antibiotics than untreated patients. The study had a flaw, however, and it didn't answer the question of who should get drugs for sinus infections.

Jahnavi Bhatt is at Mount Sinai to have her sinuses checked.

"I was waking with lots of sinus headaches," she said. "And no taste, no taste at all. I don't smell the world, I don't taste the food."

These are classic symptoms for sinusitis - inflammation and infection of the sinuses, which are the air-filled pockets of bone above and below the eyes. When they're infected by a cold virus or worse, by a bacterial germ, the sinuses clog with mucus. That can block odors from reaching the nerves of smell higher up in the nose.

Nowadays, doctors use a scope to look into the nose at the sinuses and can use a CAT scan to see the anatomy.

Dr. Ken Altman looked at Jahnavi's scan.

"Air is black, and you want air to be inside the sinuses," he said. "But you can see the mucus filling this sinus and completely obstructing the other sinus."

The question is often should you treat sinus infections with antibiotics or not? Dr. Altman says most sinus infections are the result of common cold viruses that don't need antibiotics. If colds go on beyond two weeks, it may mean a bacterial infection that will need drugs.

"The other thing is that symptoms that tend to get better and then worse again during the initial 14 day period might mean a bacterial infection that may need treatment," he said.

After treatment for the bad allergies causing her sinusitis, Janavee's sinuses were better.

And best of all, her senses of taste and smell also came back.

Dr. Altman cautions that in unusual cases, sinus infections left untreated can spread to the brain and cause brain abscesses and meningitis. If you're losing your sense of taste and smell for weeks at a time, check with your doctor.