Because penetration of antibiotics inside the sinuses is poor, an extended treatment is often necessary.

Antibiotics do not penetrate well into bone and the bacteria in chronic sinusitis are located inside bone.

Typically a minimum of three weeks or more of antibiotic treatment is necessary for patients with chronic sinusitis.

Sometimes 6-8 weeks of treatment may be necessary. In some cases multiple different antibiotics need to be used.

In some cases where patients do not get better after they have been treated with an adequate course of antibiotics, they will receive intravenous antibiotics instead of, or as preparation for surgery.

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