Intravenous (IV) antibiotics may be used to treat severe chronic sinusitis not responding to conventional therapy. IV delivery offers greater absorption of antibiotics compared to oral or nasal dosing. Thus it can reach higher blood and sinus tissue levels. Therefore IV therapy may increase the likelihood of eliminating bacteria within the sinuses within the sinuses.
IV antibiotics require placement of a PICC (Peripherally Inserted Central Catheter) line into the chest wall. PICC lines require a same day hospital or outpatient surgical center procedure. Once placed, a PICC line provides easy IV access for medications. Antibiotics can then be administered at home. This procedure is invasive and should be reserved for the most difficult cases of sinusitis.
IV antibiotic treatment for chronic sinusitis is usually carried out over 6 – 10 weeks depending on the extent of the disease. Early studies have shown improvement in quality of life and reduction in sinus symptoms. Long term studies examining recurrence rates after 3 months showed that IV antibiotics resolved chronic sinusitis in only a minority of individuals. Most who relapsed did so within 3 months. Complications occurred in 26% of those who discontinued treatment. Complications included swelling at the PICC line site, infections from the PICC line and toxicity from the antibiotic.