Cold and Respiratory Illness Season is Upon Us. Georgetown Expert Offers Tips on When to Seek Care

WASHINGTON (October 13, 2026) — With fall routines well underway, families are entering the season when colds and other respiratory illnesses begin making their familiar rounds. For some, the congestion, facial pressure, headache and runny nose may resolve in a few days. For others, symptoms may linger or worsen, raising questions about when to seek care and whether an antibiotic might help.

Georgetown family medicine physician Dan Merenstein, MD, offers guidance on when sinus symptoms warrant a visit with a clinician, what patients can do to feel better and why an antibiotic isn’t always the answer.

When to Seek Care

Among the signs Merenstein says to consider:

• How long is too long? Contact your primary care clinician if a lack of improvement begins to stretch past seven to 10 days.
• When symptoms get worse. Be alert if your symptoms start to improve but then suddenly return or intensify.
• When symptoms are severe. Never hesitate to contact a clinician when your symptoms cross into severe territory such as high fevers, severe headaches or shortness of breath.

And when you do seek care, Merenstein advises against assuming that an antibiotic will necessarily be the answer.

“Acute rhinosinusitis leaves people feeling miserable and desperate for relief, and their care providers eager to help,” says Merenstein, director of research programs for Georgetown’s Department of Family Medicine. “Unfortunately, in the absence of clinically proven treatments, clinicians often prescribe antibiotics. We want to know if there’s a better way to treat patients and alleviate symptoms quicker, while also figuring out who really benefits from antibiotics and should take them as soon as possible.”

Do You Need an Antibiotic?

Antibiotics are commonly prescribed for sinus infections. One study of nearly 4.7 million outpatient encounters among insured U.S. adults found that 82.6% of acute sinusitis encounters resulted in an antibiotic prescription.

“The problem with that is quite often these infections are viruses and antibiotics will provide no help,” Merenstein says.

But determining who actually benefits from antibiotics is a surprisingly difficult question and is one that Merenstein and researchers across the country are trying to answer.

Merenstein and his colleagues are leading the largest clinical trial of its kind to determine which treatments work best for which patients with acute rhinosinusitis.

The NOSES study will involve nearly 4,000 people at clinical sites across the country, including participants in the Washington, D.C., region. Researchers are comparing commonly used approaches to treating sinus infections, including antibiotics, intranasal corticosteroid sprays, saline nasal irrigation and supportive care.

Importantly, they are also trying to identify which patients may get better without antibiotics and which are most likely to benefit from them.

The question has implications beyond an individual case of sinusitis. Unnecessary antibiotic use can contribute to antibiotic resistance and expose patients to side effects without helping them recover more quickly.

The Real Cost of a Sinus Infection

Sinus infections don’t just make people feel lousy. They can mean missed work, lost income, disrupted child care and additional medical expenses. The broader toll underscores why finding the most effective treatments matters.

• 61.2 million potential workdays are lost annually among U.S. adults with rhinosinusitis.
• $3.79 billion in work productivity is lost annually in the U.S. due to rhinosinusitis.
• 82.6% of outpatient acute sinusitis encounters among commercially insured U.S. adults resulted in an antibiotic prescription.
• Two to three weeks is the usual course of acute sinusitis, and most people get better without antibiotics.

“Additionally, taking an antibiotic for a viral infection offers no benefit and only exposes you to potential risks,” Merenstein says.

More About the NOSES Study

Acute rhinosinusitis affects approximately15% of adults annually and accounts for nearly 30 million outpatient visits in the United States.

The NOSES study is recruiting participants through Georgetown University and five other university research sites across the country. MedStar Health Research Institute serves as the study’s data coordinating center. The research is funded by the Patient-Centered Outcomes Research Institute.

The study is actively recruiting patients from primary care offices and can also enroll participants via Zoom meetings. If you are interested please visit the website or call 202-407-6360.

“This is the kind of question patients and primary care clinicians face every day,” Merenstein says. “Our goal is to generate the evidence they need to make those decisions with greater confidence. We can only do that with the help of patients who are suffering from sinusitis.”

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