Rhinosinusitis (congested or runny nose) Management

  • Antibiotics are not needed 98-99.5% of the time

  • Most cases usually resolves in 7-10 days without treatment

  • Symptomatic management gold standard

    • Saline irrigation twice daily (Neilmed Sinus Rinse)

    • PLUS steroid nasal spray (mometasone nasal spray – “Nasonex/Sensease”)

    • PLUS short term decongestant such as pseudoephedrine/phenylephrine

Acute viral rhinosinusitis (the common cold) is the most common form of acute rhinosinusitis. It is estimated that only 0.5% to 2% of respiratory tract infections are complicated by bacterial infection. Antibiotics are therefore not useful for most acute rhinosinusitis cases.

Uncomplicated acute viral rhinosinusitis resolves in 7 to 10 days without treatment, 80% of bacterial sinusitis cases resolve in 2 weeks.


To use a nasal spray effectively and safely:

  • Clear the nasal passages first; using a saline nasal spray may be helpful.

  • Shake the bottle and follow the manufacturer's advice (package insert) about priming if needed.

  • Bend your neck forward and look down.

  • For intranasal corticosteroids, use your right hand for the left nostril and vice versa. Put the nozzle just inside the nose aiming towards the outer wall.

  • Change hands and repeat for the other side.

  • Avoid sniffing too hard or the liquid is likely to go straight down the throat.

Remember that this is just a general guide! Your doctor and pharmacist will be able to provide more advice to you about your specific symptoms.

Further Reading:

Definitely head over to Better Health Channel's sinusitis page for further reading

References: Therapeutic Guidelines Ltd (eTG March 2020 edition) March 2012. Accessed 25/04/2020 URL: https://tgldcdp.tg.org.au/viewTopic?topicfile=rhinitis-rhinosinusitis&guidelineName=Respiratory&topicNavigation=navigateTopic#toc_d1e70

This is freely available to be downloaded here:

Remember to talk to your dentist, doctor or pharmacist before using this advice. I have placed this here as a reference for my patients, only under recommendation of their clinician.

Our pharmacist at #BarcyPharm will love to hear from you!

Please get in touch via phone: 07 4651 1121, email:  barcaldine.pharmacy@nunet.com.au, or SMS: 0474337679