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Antibiotics Are Useless In Treating Most Sinus Infections
An anonymous reader writes "While doctors routinely prescribe antibiotics to treat sinus infections, researchers on Tuesday revealed that amoxicillin, the most commonly prescribed medication for nasal cavity inflammation and sinuses, was just as effective as a dummy pill. Researchers from the Washington University School of Medicine in St. Louis, Missouri, found that there was no significant difference in symptoms between patients taking amoxicillin to those who took the placebo three days after starting the pills were administered."
"there was no significant difference in symptoms between patients taking amoxicillin to those who took the placebo three days after starting the pills were administered."
Whiskey!
You can't effectively treat biofilms with antibiotics. And that is exactly what this type of infection is--a biofilm.
A better approach is the use of biofilm "release" enzymes that signal the cells within the biofilm to stop producing EPS and detach from whatever surface they are clinging to. Use of such enzymes alongside antibiotics in a medical setting is likely to work even better.
We've known for years that Doctors have over prescribed Antibiotics for many ailments, simply because people just don't want to feel miserable when they get sick. And since most people can't afford time off of work they don't take it or won't take it for fear of the backlash from a company, people still go to work and infect others and the cycle continues. The cheap solution is to take pills instead to resolve the immediate illness.
Life takes interesting turns, but the most interest is when you're off the beaten path.
amoxicillin, because there are no other antibiotics on planet earth.
yeah focus on symptoms, because progression of infection is irrelevant. three days, because all antibiotics cure by monday morning if course started friday morning
http://jama.ama-assn.org/content/307/7/685.short I can't tell if it's paywalled or not - it appears to be. Pubmed hasn't indexed it yet (not that they offer free articles from JAMA anyway).
Most sinus infections are viral. Nothing to see here.
Great warrior...hrmph! Wars not make one great.
In most cases?
Most likely, there was no measurable change between the two groups. I have had all sorts of antibiotics prescribed to me for various issues, amoxicillin is only given in the least annoying conditions by my doctor. I have done the zpacs (amoxicillin), cefalexin, and in one case I had cipro (which I will not wish on anyone, it worked but side effects were not fun and it was not for a sinus infection)
I have pretty much gotten away from drugs for a sinus infection unless it doesn't seem to sort itself out quickly. Not sure if that is good or bad, but I haven't had as many since I stopped trying to treat them with antibiotics.
I would RTFA to find out what they did to insure parity among control groups... but... its more fun to post
* Winners compare their achievements to their goals, losers compare theirs to that of others.
Azithromycin (in the form of a Tri-Pak) sure seems to make a dent in my sinus/bronchial infections.
However; when you have dark green stuff coming out of your nose and you coughing jello from deep inside your lungs, you might qualify for some good antibiotics. For milder stuff, docs recommend rest and over counter stuff. Sometimes a breathing treatment can help. Let's hope you have insurance?
Big leap from "no significant difference in symptoms between patients taking amoxicillin to those who took the placebo"
to "Antibiotics Are Useless In Treating Most Sinus Infections". How many bugs are resistant to amoxicillin at this point?
How many of the patients had bacterial infections?
more cowbell
abstract is here http://jama.ama-assn.org/content/307/7/685.abstract
story itself, paid for probably with tax dollars is paywalled
The abstract says that yes, at 3 days, amoxicillin and placebo similar, but there was a diff at day 6
Also, total number of patients studied is quite small - Typical Bull**** "MD" science - mds just don't know how to do science, and they constantly flood the literature with these worthless studies, so the net result is a negative, cause you have towaste brain power to not pay attention
However, what is of more interest is the hard to read format of the abstract, which is a deliberate format imposed by the medical journals; the use of statistics in parenthesis, eg quote, mean difference between groups of 0.03 [95% CI, 0.12 to 0.19]) and on day 10 (mean difference between groups of 0.01 [95% CI, 0.13 to 0.15]), but differed at day 7 favoring amoxicillin (mean difference between groups of 0.19 [95% CI, 0.024 to 0.35]).
makes the abstract almost impossible to read; this practice has been criticized, but the idiot mds of course don't listen.
Not only that, with the number of people in the study, if you know naything of the history of medical studies, to give CIs is just BS, crazy statistics for no reason other then to tget a publication or satisfy the wierdness of hte editors; everything that is wrong with academic medicine is in this abstract
sorry for rant
A) Someone's got a sense of humor: "The primary outcome was measured using the modified Sinonasal Outcome Test-16 (SNOT-16), a validated and responsive measure."
B) They did no testing whatsoever to ensure the sinus infections _were_ bacterial - but they apparently usually are, and are usually diagnosed as such symptomatically instead of by culture (in other words, they followed normal practices in deciding who to give antibiotics to).
C) They did no testing to see if resistant bacteria could be isolated from any patients.
Putting B and C together...clearly the medical community is overprescribing antibiotics, but there may be some question of whether it's resistant bacterial infections or poor diagnosis of bacterial vs. viral infections.
THE AC submission was alarmist and wrong.
The research did not show the anitbiotics are useless.
It showed the Amoxicillin had no significant statistical difference at day three. BUT statistically significant results on day 7, no difference on day 10.
What this means is the people taking Amoxicillin got better sooner.
The person who wrote the headline and summary should be ashamed of themselves.
The Kruger Dunning explains most post on
Doctors have a tendency to recommend things that only they can recommend: prescription drugs, surgery, etc. They figure if you could do it yourself you'd have already done it.
But there's an ancient treatment for sinus problems that works really well: nasal irrigation. Basically, you add 1/2 tsp salt to a cup of water, and flush that through your nasal cavity.
Wall Street's media was overjoyed when someone with parasites in their water supply recently died after they used their neti pot. So boil your water first if that's a problem where you live, mkay? (This is covered on the link above...)
Learn the rules so you know how to break them properly.
www.teslabox.com
This is no different than the common cold, 90% of which come from a virus instead of bacteria.
I went to eat some animal crackers and the box said, "Do not eat if seal is broken." I opened the box and sure enough..
i currently a) have a sinus infection, b) am taking amoxicillin to treat it, and c) am completely miserable. hey science, thanks for making my day even worse!
Can someone tell me where I can buy a pack of placebos please?
They seem to be really usefull in fighting off all sorts of diseases.
"That's the way to do it" - Punch
Are antibiotics ineffective on sinus infections because the infection is viral and not bacterial or could it be that the common bacteria responsible for such an infection has grown resistant to the antibiotic?
It is entirely possible for a virus to give tissue damage that then results in a bacterial infection or visa versa!
Hence, I can easily believe that a rhinovirus could easily prevent clearing up a sinus infection with bacteria.
Biofilms, as mentioned by others, may also be an important variable.
It is anything but simple "Yes or No."
A Mayo clinic study found 70% of sinus infections are viral instead of bacterial, so antibiotics actually make the infection worse. In addition, the antibiotics harm the rest of your immune system, leaving your worse off than before. My ENT introduced me to anti-viral nasal sprays for sinus infections. More of the drug reaches the infection and your GI system is left unharmed. The catch is they must be compounded at a pharmacy, need to be refrigerated, and are only good for 30 days. Many insurance companies cover them, but a lot of doctors don't know that option exists and just prescribe antibiotics.
the antibyotics factories have a different view. Very different.
Sent as ripples into the electromagnetic field. No single photon has been harmed in the process.
I noticed this study was only conducted on adults. I'd be curious if the results would be replicated in children as well. When my kids were younger, they had sinus infections at least twice a year and would get amoxicillin every time. If a sinus infection would clear up on its own about as fast, there wouldn't have been as much need for the constant doctor visits.
The article says sinus infections account for 20% of all antibiotics prescribed for adults. I'd be surprised if that number wasn't over 50% for kids. Not using antibiotics for sinus infections would be a huge help in reducing antibiotics use. On the other hand, it would probably be devastating for pediatric clinics.
Works every time, costs pennies and has almost no side effects. Don't need a prescription for it either.
Anyone who has been to the doctor for a sinus infection has been told that they are rarely bacterial in origin, and are almost exclusively viral.
They give antibiotics as a precaution and as a placebo, as patients feel better taking *something*, regardless whether it is effective.
while(1) attack(People.Sandy);
I inherited bad sinuses from my mother who occasionally gets wicked sinus infections and has to go on hardcore antibiotics, the kind that WIPE your digestive tract and turn your poo white.
Fortunately for me genetics diluted the problem and I don't get one more than once a year usually. I've tried to tough it out, load up on decongestants and expectorants (due to drainage) etc and all that happens is it gets my throat torn up like hamburger from the infected runoff combined with coughing. Lucky me, I'm going through my yearly round of that right now actually. I started myself on decongestants immediately and have been pounding down pepsi almost nonstop to try to keep my sinuses and throat clear, but it still looks like the throat version of red-eye in there. I might actually beat it without antibiotics for the first time this time since I've jumped on it so aggressively.
In the past it's usually been the same story. Try to use over-the-counter meds for a week, finally it is getting so bad that the yellow mucus overnight has my throat destroyed by morning. (which will improve somewhat during the day, but not enough, it's a losing battle day to night) Enough of those and I can't stop coughing and I sprint into the local "convenient care" before work and a random doc looks at me and prescribes a decongestant and expectorant (that cost 2x the OTC usually) saying he doesn't want to give me antibiotics YET. Thanks.
So I'm back in the office 3-4 day later, almost unable to talk, haven't slept in days, throat killing me, and throat is totally red with green mucus streaking down in the back. "Ooooh! you have a bad sinus infection now! Here's some antibiotics!" Thanks. Now why couldn't we have just done this three days ago instead of putting me through two days of hell?
So the last two times I went in I relayed the above story and they conceded maybe antibiotics before it gets REALLY bad is a good plan for me. And I was sooo thankful, instead of it taking several more days of winding down misery, another two weeks in all, one round of refills to clear up, it was much better the very next day and cleared up in 5 days, both times.
Whoever says antibiotics don't help sinus infections is a quack. I seriously wonder what would happen to people like me if there were no antibiotics, could it get bad enough to hospitalize or kill me?
I work for the Department of Redundancy Department.
Even if they can cure it, aren't antibiotics reserved for serious illnesses that can't be cured by other means? You can cure a cold dozens of other ways without breeding a new strain of resistent bacteria, what the hell is wrong with you Americans?
If you feel any sinus pressure or notice any drainage, gargle with warm salt water, and use saline nasal spray.
If the pressure is acute, take a nasal decongestant.
If you do the above early enough, you will stop getting sinus infections.
p.s. PRO-TIP: You can refill nasal spray bottles with filtered water and table salt.
20% of patients continued to have symptoms after ten days in each case, by my reading. This indicates to me the formation of a strong biofilm, which antibiotics will be next to useless against.
Also, slashdot was never great. It's not much different now than it has been for the last ten years, except that now there are a lot fewer dupe articles.
I sprint into the local " convenient care " before work and a random doc looks at me and prescribes a decongestant and expectorant (that cost 2x the OTC usually) saying he doesn't want to give me antibiotics YET. Thanks.
So I'm back in the office 3-4 day later, almost unable to talk, haven't slept in days, throat killing me, and throat is totally red with green mucus streaking down in the back. "Ooooh! you have a bad sinus infection now! Here's some antibiotics!" Thanks. Now why couldn't we have just done this three days ago instead of putting me through two days of hell?
So the last two times I went in I relayed the above story and they conceded maybe antibiotics before it gets REALLY bad is a good plan for me. And I was sooo thankful, instead of it taking several more days of winding down misery, another two weeks in all, one round of refills to clear up, it was much better the very next day and cleared up in 5 days, both times.
Maybe if you established a relationship with a regular GP or ENT Dr, maybe he would become familiar with your history and not wait to prescribe the antibiotics?
(cue flamefest from people who don't have health insurance...)
the preceding comment is my own and in no way reflects the opinion of the Joint Chiefs of Staff
I'll just leave this here...
Moral of the story, if you live in a third-world country without a safe drinking water supply, like Louisiana , you might want to boil your water before filling your sinuses up with it with a neti pot. Or else you might get a bad case of microscopic brain-eating monsters.
the preceding comment is my own and in no way reflects the opinion of the Joint Chiefs of Staff
Thats kind of like saying exercise is dangerous because someone in Louisiana was run over while jogging down the middle of the interstate. Amoebas are dangerous even if you drink them.
My doc irrigates himself, and says it works best with Manuka honey.
I guess it's too late for someone to trademark and market Placebo? How much more should they charge for higher dosages? You can't get in trouble with the FDA as long as you make no claims of efficacy for any particular malady, right?
the preceding comment is my own and in no way reflects the opinion of the Joint Chiefs of Staff
Your intestine has about a kilogram of symbiotic bacteria, with dozens of major species and hundreds of minor species. When you take antibiotics, you wipe out some or most of those species.
The bacteria in yogurt (usually a single species) are completely different. You can't repopulate the normal bacteria of your intestine with yogurt.
Nobody knows exactly how bacteria repopulate the bowel, but one thing you could try is a fecal transplant -- in other words, eat shit. This is not a standard medical procedure, but it's under serious investigation.
One of the problems with destroying the normal gut flora with antibiotics is that the gut is a major immunological organ. The immune system (all those white blood cells) has to decide whether a bacterial species is a normal symbiote or a pathogen, which is difficult and inaccurate. If you wipe out the normal flora and start again, your immune system might make mistakes.
Nobody knows what causes autoimmune diseases like multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosis, Crohn's, inflammatory bowel disease, etc., but wiping out the normal gut flora with antibiotics is a plausible mechanism.
So using antibiotics when you don't need them, in addition to promoting antibiotic resistance, might give you one of those horrible autoimmune diseases.
I'm not a doctor, but I don't think viral infections last that long, and fungal disease is quite separate, and would be very VERY messy. If the doctors can't tell the difference between an infection and an allergy, then they must be voodoo witch doctors.
don't treat it; the it spreads to my lungs. I can handle a stuffy head but not being able to breath properly at all is just unbearable.
I have a lot of experience on this subject: p>
I get 1 or 2 sinus infections a year and the antibiotics don't work for me. With that said, i found out that Pseudoephedrine is far better for me because it reduced my sinuses and relieved the pressure that goe's along with it and i just rode what pain i had for 3 to 5 days so the sinus cavity could dry out and i would be fine.
I'm here for the experience, not the Hyperbole.
I used to get "sinus infections" a lot up until 5 years ago. Usually in the spring and the fall. Doc said it's cause of all the mold in the air then. *cillin isn't that useful for this and the last time he gave me Ciprio. Awful stuff. Makes you utterly lactose intolerent and one bowl of clam chowder let me now what cholera must feel like.
Turns out though, that oregano oil is chesaper, safer, quicker and more effective than any antibiotics I've ever tried. I don't even get them any more. But, everyone who has a "head cold" - which is often how a sinus infection presents, should try this.
Oregano oil is really really strong. This does bit a little, but you fell better pretty much immediatly. Oregano oil is one of the strongest anti fungals known, it's anti-viral and kills bacteria so well a recent university of bristol (?) study fond it not only kills MRSA (as Mayo found out) but does do so in stupid low concentrations.
It's also good in pizza and/or spaghetti sauce. Use one drop.
Here's how you treat your sinuses with it: http://rs79.vrx.net/opinions/ideas/medicine/oregano/sinus/
Notes: /. - wow.
1) all synthetic medicine has side effects. avoid antibiotics if you can
2) i've seen more bad advice on this page than I'm even used to on
3) make sure you get organic oregano oil. when you concentrate things this much any traces of pesticide or what have you become significant. you want to avoid that.
Need Mercedes parts ?
Here's the rub. Part B) isn't likely to be correct. I'm hedging because the science behind that statement is rather iffy but:
If you attempt to isolate bacteria from either the nasal turbinates (the boggy things in your nose) or the sinuses themselves in the first week or so of an infection, you very rarely grow anything. Note that the study started antibiotics early, typically around day 3. If you wait longer, you pick up more bacteria but still you don't pick it up all of the time, even in chronic sinus infections.
The lack of bacterial cultures in early sinusitis can be due to a couple of things: 1) There are no bacteria - it's viral 2) You aren't culturing the right bacteria - clinical studies typically only attempt to grow the usual suspects. Finding a 'new' bacterium is rather difficult. 3) You're doing it wrong (not obtaining or growing the culture correctly, basically lab error) 4) The bacteria are causing a problem but aren't found where you were looking (say in a biofilm or in the bone as is found in chronic sinusitis).
Unfortunately, I don't have electronic access to JAMA and I think I tossed that issue. My hissy fit morning mental states makes we want to state that it's a pretty weak article and certainly getting more press than is due. It's really clear that the media is hyping this way too much.
I think I'll go for a walk now. I feel happy....
Faster! Faster! Faster would be better!
Useless, because it makes no mention of the difference between viral and bacterial "sinus infections". If, by "sinus infections", we mean upper respiratory infections, then the vast majority of those are viral and will not respond to antibiotics (duh...). I find it hard to believe that a credible study would fail to make this distinction, but it's impossible to tell from TFA. Then again, the will-nilly prescription of antibiotics when patients demand it, even when the clinical picture says "virus", is all too common, so who knows.
I went in with sinusitis. I couldn't smell anything. Doc give me an antibiotic. Went on a two-week trip out west. The antibiotic did nothing for the sinusitis and I foolishly took it to completion. By the end of the trip I had a raging infection.
Another doctor prescribes Zithromax. In 5 days sinusitis is gone and so is my sense of smell.
Seems the first antibiotic killed every bug except the one causing the infection, allowing it to take over my entire schnozola. The second antibiotic killed that bug off. But for some reason I retain some congestion.
my sense of smell sensors are intact - I occasionally can smell or, if I snort, I can sometimes smell. Helluva way to eat with friends: snort, eat, snort, eat.
It's dated 2/15/12 - I would guess you don't have it yet, as opposed to tossing it already (?)
When I presented with a chronic sinus infection the doctor told me that antibiotics were pretty much useless against infections in this part of the body because it was mainly in the mucus and there was no blood-flow in mucus so the ABs couldn't properly permeate that medium.
Never the less, he gave me a course of ciprofloxacin which, I'm told, is one of the "least ineffective" ABs for this kind of infection -- and one with some nasty side-effects.
The infection did abate for a while but (despite the fact I took a 2-week course) it came back.
With nothing to lose, I decided to try a natural remedy which is an "over the counter" supplement containing garlic and horseradish.
Voila!
It hasn't totally killed the infection but keeps it at such a very low level that you wouldn't know it was there. However, if I stop taking the pills I can feel the infection returning so I just pop a pill every couple of days and my quality of life is restored - with no side effects (it's odorless garlic).
I'm not one of these "save the planet hippy fad anti-establishment alternative therapy" types -- but sometimes I think we are just too quick to accept that hi-tech drugs are the only answer to problems.
I guess it's more viral than bacterial. A lady who suffers from chronic sinus infections says hot showers work for her. Here's a video on the research that was conducted to indicate that antibiotics do not work to tackle sinus infections. http://www.patexia.com/feed/video-commonly-prescribed-antibiotics-not-effective-for-sinus-infections-2729
The pattern is: a sinus infection clogs your nose somehow. Then you start breathing through your mouth. Then your throat gets irritated so you cough. Then you damage your throat, or your bronchiae, and then a bacteria moves in. And Amoxicilin *does* work against those.
Moral of the story ? Keep your nose clean and drink lots of water. Just like your moma said you should.
Religion is what happens when nature strikes and groupthink goes wrong.
I get infections an average of once a year. About 2/3s of the time I can fight them off with a combination of rest, sinus irrigation, and antihistamines. When that fails, I do not get better without a course of antibiotics. I have waited weeks to months before going to the doctor for the prescription. In my case I strongly doubt that it's a placebo effect.
This leads me to ask if the problem is one of selection, meaning that maybe doctors are either writing prescriptions too soon or they need another data point to make an accurate diagnosis.
Spyder
I toss stuff pretty fast these days. Especially JAMA....
Faster! Faster! Faster would be better!
When treatment for Lyme disease wrecked my bowels, I went to the health food store and bought every damn live thing they had on the shelves. Yoghurt, kombucha, goat cheese, all kinds of weird stuff that tasted funny. Only criteria was that it should be alive.
It took me a couple of days to eat it all, and some of it was pretty stinky. I drank water right out of the stream outside my house to wash it down.
It was very unscientific because I didn't measure anything, but it worked. Kind of russian roulette approach, but I was in some distress at the time and willing to gamble. Mainstream medicine did not have any effective cure.
I tried amoxicillin for my sinus infection in its first year. Nothing happened, bar placebo effects, and now the infection is four years old and nothing can touch it. Maybe it's fungal. Maybe not. I just hope at least surgery can remove it, one day. It's annoying
Turn your head sideways, and run the salt water in from the top nostril and out the bottom. Gravity does the work for you.
Then flip around and run it the other direction. Give your nose a good blow and you will feel great.
If it burns too much, add more salt to the water. A bulb syringe works fine. I often find them in the baby section.
I only look human.
My mother is a halfling and my dad is an ogre, so that makes me an Ogreling
Fortunately for me genetics diluted the problem and I don't get one more than once a year usually. I've tried to tough it out, load up on decongestants and expectorants (due to drainage) etc and all that happens is it gets my throat torn up like hamburger from the infected runoff combined with coughing. Lucky me, I'm going through my yearly round of that right now actually. I started myself on decongestants immediately and have been pounding down pepsi almost nonstop to try to keep my sinuses and throat clear, but it still looks like the throat version of red-eye in there. I might actually beat it without antibiotics for the first time this time since I've jumped on it so aggressively.
As someone who has similar (but milder) seasonal issues, I'm wondering... do you rinse [1] your nostrils? Do you keep your house air clean (HEPA or whole-house filter)? How about cortico-steriods [2]?
I've also found much relief with some anti-allergens like cetirizine, which also reduce inflammation.
[1] http://www.neilmed.com/usa/sinusrinse.php
[2] http://allergies.about.com/od/noseandsinusallergies/a/nasalsprays.htm
Make sure everyone's vote counts: Verified Voting
Any doctor that says this:
"I take it you are familiar with evidence-based medicine? It’s the increasingly accepted approach for making clinical decisions about how to treat a patient. "
Is not to be trusted with new science discoveries.
http://bacteriality.com/2008/04/13/wolcott/
He found some correlation, then assumed it was correct. Whenever something he thinks doesn't work, he blames the system.
Maybe he is on to something, but no one else seems to eb able to repeat what he claims, and he isn't really using in rigorous testing I could find..not that the lack of science has prevented him from practicing it.
walks like a duck.
The Kruger Dunning explains most post on
I take amoxicillin quite frequently for a certain reason (no, I'm not a porn star). I got the world's most annoying headache after my gf at the time went to the doctor for sinus problems.
Next day, she's perfect and I'm miserable. As it should be, right? Well, we aren't married.
Asked her what she took, azithromycin. I rummaged around in my pharmacy (I'm not perfectly healthy year round) and found a spare course. Took it, next day I'm perfect. I finished the course, of course of course.
I was already on Moxy, and it didn't stop nor prevent the problem. Zith did.
On a side note, I started a course of Moxy, and realized I didn't have enough. Before the doc got me set up with more, I went without for a few days. I don't want to be gross, but I got the most incredible fountain-butt diarrhea I can remember. Garden hose blasts with nothing more solid than Hi-C. I dig back in my stash and quickly fix the "traveller's diarrhea" I caused myself, with Xifaxan.
Antibiotics, used correctly, are quite possibly the wonder drugs of the 20th century, based on the number of lives and limbs saved. Used incorrectly, we will go extinct.
I just wish they would test for bacteria first. Obviously you needed them, but it's hard to tell from symptoms alone. I keep reading about faster and cheaper genetic testing. Or labs on a chip. When do we get the instant virus/bacterium differentiator?
https://en.wikipedia.org/wiki/List_of_bestselling_drugs will guide you.
Casteism
Talk about bullshit research. Any doctor who prescribes amoxicillin for sinus should be struck off. Any competent doctor already knew this without research as it is quite apparent every time they had a sinus culture done.
I feel for you. I get a similar (but apparently not as intense) sinus infection about once a year. In the past I have tried to avoid antibiotics as much as possible, but sometimes resistance really is futile, unfortunately. If I can't keep it under control it ends up going down to my chest then I end up with bronchitis.
Anyway, among the many things that I do to try to keep it under control are the antihistamines and decongestants like you. I also use the neti pot nasal rinse like many others have mentioned in their responses to you.
However, as far as your throat infection goes, or actually any throat infection regardless if it's from a sinus infection, the BEST thing that I've ever found for it, and I'm surprised no one has mentioned it yet, is apple cider vinegar. Look it up for more details, but I basically cover the bottom of a cup or mug with the vinegar (in other words, about a 1-2mm layer) and then almost fill up the rest of the cup with lukewarm water, and then gargle with it. Alternate with having a drink of it too (it's good for you in several ways). Make sure to brush and rinse your teeth afterward so it doesn't damage the enamel. It stings/burns to do it but you will be amazed at the results. At least for isolated throat infections it gets rid of them within a day or two.
Good luck!
It's nice to hear from someone who has it worse than me.. Most of my colds turn into
sinus infections which can hold on for many weeks. Antibiotics clear them up within
days.
more cowbell