What is Sinusitis?
Sinusitis is inflammation of the paranasal sinuses — the air-filled cavities surrounding the nose and eyes. It affects approximately 30 million Americans annually and is one of the top reasons for antibiotic prescriptions, despite the fact that 90–98% of acute sinusitis cases are caused by viruses (rhinovirus, influenza, parainfluenza). Secondary bacterial sinusitis affects only about 0.5–2% of acute cases, caused most commonly by Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis.
The IDSA defines acute bacterial rhinosinusitis (ABRS) by: symptoms lasting 10+ days without improvement; severe symptoms with high fever (≥39°C) with purulent discharge for 3–4 consecutive days; or a "double worsening" pattern — initial cold improvement followed by worsening fever, headache, or nasal discharge. Telehealth evaluation allows your provider to apply these criteria rigorously and avoid unnecessary antibiotic prescribing while ensuring bacterial cases receive prompt treatment.
your board-certified provider, uses evidence-based IDSA sinusitis guidelines to guide every evaluation. He is licensed in DE, MD, and WA.
Common Symptoms
Nasal congestion or blockage
Thick, discolored nasal discharge (yellow or green)
Facial pressure around eyes, cheeks, or forehead
Reduced sense of smell or taste
Post-nasal drip causing sore throat or cough
Headache worse when bending forward
Tooth or jaw pain (maxillary sinusitis)
Fatigue and general malaise
How Innocre Treats Sinusitis Online
your provider will assess symptom onset, duration, pattern, and severity to distinguish viral from bacterial sinusitis. For confirmed ABRS, first-line treatment per IDSA guidelines is amoxicillin-clavulanate (Augmentin) for 5–7 days in adults. For penicillin-allergic patients, doxycycline is an appropriate alternative.
For viral sinusitis — the most common case — evidence-based supportive care includes intranasal saline irrigation (Neti pot or nasal rinse), intranasal corticosteroids (fluticasone, mometasone) to reduce inflammation, decongestants (pseudoephedrine orally, or oxymetazoline spray for ≤3 days), and adequate hydration. These measures promote mucociliary clearance and symptom relief without promoting antibiotic resistance.
Prescriptions are sent electronically to your preferred pharmacy in DE, MD, or WA. Follow-up is recommended if symptoms do not improve within 3–5 days of antibiotic initiation, or if they worsen at any time.
⚠️ When to Go to the Emergency Room
Telehealth is appropriate for most sinusitis cases. However, seek emergency care immediately if you experience:
- • Severe headache with stiff neck, photophobia, or altered mental status — possible meningitis
- • Swelling around the eye or eyelid (periorbital or orbital cellulitis)
- • Vision changes, double vision, or eye movement problems
- • High fever above 103°F (39.4°C) not responding to antipyretics
- • Forehead swelling or intracranial symptoms: sudden severe headache or neurological changes