Healthcare professionals may prescribe antibiotics for types of rhinitis that are associated with bacterial infections. Treatments for other types of rhinitis include antihistamines, decongestants, or steroids.

Rhinitis is a common condition that occurs when the tissue inside your nose becomes inflamed. This can cause a runny nose, sneezing, and congestion.

Rhinitis can be acute (short term) or chronic (long term). Two main types of rhinitis exist:

  • Allergic rhinitis results from an allergic reaction to environmental triggers like pollen, dust, or pet dander.
  • Nonallergic rhinitis may result from an infection like the common cold, certain medications, or environmental irritants like smoke or fumes.

Treatment for rhinitis depends on which type you’re experiencing. Common treatments include:

  • antihistamines
  • decongestants
  • steroids
  • avoidance of allergy triggers

In some cases, doctors may prescribe antibiotics for rhinitis caused by or associated with a bacterial infection.

Read on to learn more about when antibiotics are used for rhinitis and how effective they are.

Antibiotics are medications that fight bacterial infections. So doctors may prescribe antibiotics to treat rhinitis that is caused by a bacterial infection. This may include the following types of rhinitis:

Acute bacterial rhinosinusitis

The term “rhinosinusitis” refers to inflammation of both the nasal cavity and sinuses.

Acute bacterial rhinosinusitis (ABRS) results from a bacterial infection that may last up to 4 weeks. ABRS usually happens when a viral infection like the common cold progresses into a bacterial infection.

Symptoms may include:

  • congestion
  • thick, opaque, or colored nasal discharge
  • facial pain

Doctors may prescribe antibiotic therapy to fight the bacterial infection.

Chronic rhinosinusitis

Chronic rhinosinusitis (CRS) may last for 12 weeks or longer. It involves inflammation of the nasal cavity and sinuses.

Symptoms may include:

  • thick, opaque, or colored nasal discharge
  • congestion
  • facial pain, pressure, or fullness
  • loss of smell

Doctors may prescribe antibiotics for CRS when a sudden worsening of symptoms occurs.

Atrophic rhinitis

Atrophic rhinitis is a chronic nonallergic form of rhinitis that’s common in tropical countries. It occurs when the tissue inside the nose thins and hardens, causing the nasal passages to widen.

Symptoms may include:

  • crusting
  • nasal discharge
  • nosebleeds
  • foul odor
  • loss of smell

One factor contributing to the condition may be a bacterial infection in the nose. Doctors may prescribe an antibiotic ointment to apply to the inside of the nose to kill bacteria.

When should antibiotics not be used for rhinitis?

Antibiotics are not effective for:

  • allergic rhinitis
  • acute viral rhinitis, which is usually caused by the common cold

This is because antibiotics are effective against only bacterial infections, not allergic reactions or viral infections.

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Doctors may use different antibiotics to treat various forms of rhinitis.

For ABRS, doctors may prescribe oral amoxicillin as first-line antibiotic therapy. Amoxicillin is a narrow-spectrum antibiotic, which means it targets fewer bacteria than broad-spectrum antibiotics. This helps avoid the growth and spread of antibiotic-resistant bacteria.

Amoxicillin is a penicillin antibiotic. If you have an allergy to penicillin, your doctor may prescribe an alternative, such as doxycycline or a respiratory quinolone (also called fluoroquinolones).

For moderate to severe infections, a doctor may choose to prescribe oral amoxicillin-clavulanate, which is a broad-spectrum antibiotic.

If your symptoms do not improve within 3 days, the doctor may increase the dosage or have you switch to a different class of antibiotics. Options include:

For CRS, doctors may prescribe oral antibiotics such as:

For atrophic rhinitis, doctors may prescribe the topical antibiotic mupirocin as a nasal ointment. This antibiotic is used to treat infections in the nose caused by certain strains of the Staphylococcus aureus bacteria.

Current guidelines recommend that adults take oral antibiotics for rhinitis for 5–10 days.

However, research from 2009 suggests that a shorter period of up to 5 days may be just as effective and associated with fewer side effects. More recent research needs to be done to confirm these earlier findings.

Your doctor will monitor you during this period to see whether the treatment is effective. They will consider changing your treatment if your symptoms:

  • do not improve within 7 days
  • worsen at any time

In the case of mupirocin nasal ointment, you apply it to the inside of each nostril twice daily for 5 days. Your doctor will give you specific instructions for how long to take the medication.

Research from 2014 suggests that antibiotics are moderately effective for the treatment of ABRS. Yet about two-thirds of people with ABRS recover without antibiotic therapy.

To avoid unnecessary treatment with antibiotics, a doctor may first choose to monitor your symptoms for 7–10 days. If symptoms worsen or do not improve, the doctor may prescribe antibiotics to fight the infection.

A 2020 study found little evidence to support the benefit of systemic antibiotics to treat CRS. Current guidelines for CRS recommend first-line treatment with saline nasal irrigation or topical corticosteroids.

Some research from 2009 suggests that topical antibiotics are moderately effective for atrophic rhinitis. However, a 2012 review of research found a lack of evidence on the long-term benefits of treatments for atrophic rhinitis, including antibiotics. More research is needed.

Antibiotics may be used for types of rhinitis associated with a bacterial infection. This includes ABRS, CRS, and atrophic rhinitis.

Research suggests antibiotics are moderately effective for bacterial infections related to rhinitis.

Some types of rhinitis, such as ABRS, may resolve without antibiotic therapy. Other types of rhinitis may require different treatments, such as antihistamines, decongestants, or steroids.

The most effective treatment option for rhinitis depends on the type of rhinitis you’re experiencing and its underlying causes. Talk with a doctor about the most effective treatment options for you.