The treatment of acute and chronic sinusitis often varies significantly. Acute sinusitis will often resolve with supportive care or a brief course of antibiotics, while the treatment of chronic sinusitis is often much more complex. . Deciding on the best treatment option requires an accurate diagnosis as well as weighing the risks and benefits of any give treatment option. Once a treatment decision is made, patients should approach their treatment with confidence, a positive mental attitude, an understanding of the anticipated outcome, and realistic goals for recovery.

Acute sinusitis: Because the symptoms of viral upper respiratory tract infections can be identical to acute sinusitis, and the fact that about 50% of acute bacterial sinusitis will resolve spontaneously, it is common to assume that sinus symptoms lasting less than 5 to 7 days in duration are viral and do not require an antibiotic. Over the counter medications that are commonly used to initially treat these symptoms include: decongestants, mucous thinning agents, saline irrigations, steam inhalation, and adequate intake of fluids. Antihistamines are not generally recommended except in the case of underlying allergic disease.

If symptoms persist for greater the 5-7 days, antibiotics may be prescribed to control the symptoms of acute sinusitis. For acute sinusitis, a seven to ten day course of antibiotics is usually effective, although more recently a number of shorter duration antibiotic regimens have been developed.