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- Jun 17, 2002
I'm lucky to not have any real nasal issues but my wife has them pretty bad. She uses Xyzal, Flonase, Olopatadine and Singular daily and will get a raging sinus infection about once every 3 months that can require 2-3 rounds of antibiotics.
I am not against using additives in nasal irrigation, but I would hesitate to use shampoo. Surfactants and thin mucosa seem problematic. Have you ever tried Alkanol for irrigation? My wife uses it when hers gets bad and its preserved so any residual left in the sinuses has low chance for microbial growth. Also, NAC has biofilm disrupting properties. If you're flushing with shampoo a little NAC doesn't seem too crazy.
I used to have chronic sinus infections as well. Probably 10 or so years ago I found about a Gentamicin nasal rinse they were using at Mayo Clinic. Its 80mg/L and you simply take 20 ml and put it in a bulb syringe and lie on your side and put it in your nostril, let it sit 30 seconds, and sit up and let it drain out and switch sides and repeat. I do that in the morning and evening after my nasal irrigation. I have not had a sinus infection since. Gentamicin is an antibiotic and while toxic to the kidneys, none of it is absorbed systemically(besides it microdosed) and any compounding pharmacy can make up the solution with a Rx.