Nasal antibiotics and antifungal treatments can be sprayed directly into the nasal passageway. These treatments may help decrease the development of sinus disease if you are prone to recurrent sinusitis. Application of a nasal antibiotic ointment like mupirocin (Bactroban®) or polymyxin B (Polysporin®) can help reduce acute relapse of sinusitis. Using nasal amphotericin (an antifungal drug) for 3 - 6 months has also been recommended for chronic sinusitis. These medications are usually well tolerated, though there have been some reports of nasal stinging.
Antibiotics can be aerosolized by a nebulizer into the nose and sinuses. Nebulization produces very small particles that can penetrate the sinus passageways. Medications are directly delivered to the infected sinus tissue and/or decrease the bacteria located in the nose. Aerosolized medications can be delivered in higher concentrations than medications taken orally or intravenously. The SinuNEB® irrigation nebulizer system has been particularly helpful in this regard.
Nebulized antibiotics are considered a treatment option if oral antibiotics have not been effective. There have been limited studies on the effectiveness of nebulized antibiotics compared to oral antibiotics in chronic sinusitis. Nebulization of antibiotics for the treatment of chronic sinus disease has been used in Japan for many years. However administration of nebulized antibiotics for chronic sinusitis in the United States has not been widely tested. A typical course of treatment is nebulization twice a day for 2 - 3 weeks. Side effects of nebulized medications include dryness around the nose and lips, cough, tongue or throat irritation and at times asthmatic reactions.