Topical antibiotics for sinus/throat infections -- why not?

September 20, 2006 11:39 PM

Topical antibiotics for sinus/throat infections?

So I had what appeared to be a low-grade sinus infection; now it's left my sinuses (for the most part) and has lodged in my throat, where it seems to be thriving more and more each day. In a moment of despair over the realization that I may need to visit the doctor to ask for antibiotics, a weird thought flashed through my mind: why not apply some sort of topical antibiotic to the affected area? I'm not about to try it, mind you -- but it made me wonder why we can apply topical antibiotics to external wounds/infections, but not to ones inside the sinuses or throat. What's the difference? Is it that the antibiotics take too long to be absorbed, even given that mucus membranes absorb things pretty well? Is it that the throat/sinus infections are somehow rooted more deeply in the tissue than, say, an infection from a torn hangnail?

posted by treepour to health & fitness (10 comments total)

There are topical gargles for this kind of thing that have antibacterial activity. Chlorhexidine comes to mind.

Your throat and sinuses are constantly being flushed by saliva and other serous and mucus secretions, though. That makes it hard to keep a topical antibiotic in place for very long.

Ever take erythromycin, clarithromycin or azithromycin? You can taste it in your saliva. You can see how if the flushing secretion had antibiotic in it, the whole question of how to get the antibiotic to stay in place becomes moot.
posted by ikkyu2 at 12:18 AM on September 21, 2006

Oh how I hate that plasticky taste, ikkyu...

How, exactly, are you going to get a topical antibiotic into your sinuses? I think a spray wouldn't get enough up in there, and/or come right back out like ikkyu said.
posted by IndigoRain at 3:49 AM on September 21, 2006

The connection - hole - between your sinuses and nasal cavity is only about the size of a pencil lead. Which is why, when the tissues swell, that it gets blocked easily and you end up with a sinus headache. Spraying things up your nose isn't going to get into the sinuses to any significant extent.

For your throat, just gargling with listerine works. Note that you may not have much of a throat infection - your throat may be primarily irritated by drainage from your sinuses running down it all night (which is common), so your throat will stop hurting when the sinus infection is cleared up.
posted by jellicle at 4:00 AM on September 21, 2006

Ear infections are often treated this way, usually with a drug suspended in a liquid (ear drops) though occasionally with a powder (mastoid powder - the one I'm familiar with, as I'm on it right now, is a mixture of an antifungal, an antibiotic, a corticosteroid for inflammation, and boric acid to dry things up).
posted by spaceman_spiff at 4:42 AM on September 21, 2006

In the "before time", they used to paint sore throats with merthiolate. Don't ever do this, in case they still make merthiolate. Eventually, you are likely to become allergic to it, which means all mercury compounds.
posted by unrepentanthippie at 5:06 AM on September 21, 2006

My ear, nose and throat doctor told me NEVER to gargle with mouthwash, it irritates the hell out of stuff. Warm salt water is what they recommend.
posted by chococat at 5:57 AM on September 21, 2006

Spoonfuls of honey.
posted by popcassady at 7:30 AM on September 21, 2006

I think the issue is that the topicals wash away too quickly and don't provide high enough concentrations to have a significant antibiotic effect.

Please note that the sinusitis treatment guidelines have changed: antibiotics should be withheld for 10-14 days unless you get a fever, facial pain, or eye swelling.

Hydrate yourself, rest, and take some OTC products for congestion.
posted by gramcracker at 8:11 AM on September 21, 2006

I guess i kind of missed the MetaFilter Bus on this one, but almost every time I think I'm coming down with a cold/sinus infection and sore throat, I take an over-the-counter antihistamine and it clears right up, sore throat and all. If you don't/didn't have evidence (colored goo) of a bacterial infection, you may have had a virus, or simply allergies.
I hope I'm not insulting you by suggesting that you don't know your bacterial infection vs. allergy, so if you're confident about this, carry on. And gargle with salt water.
posted by pullayup at 4:20 PM on September 21, 2006

Good info & thoughts, all. Thank you.
posted by treepour at 6:24 PM on September 21, 2006