For Acute Infections
For acute infections and significant inflammation I recommend purchasing Afrin (Oxymetozaline) Nasal Spray and a Neilmed rinse kit. Generously use the Afrin spray to topically decongest the sinonasal passages. After a few minutes rinse out the nose with your Neti pot or sinus rinse kit. (See our online video for a demonstration). Following that, use your nasal steroid spray as directed. Repeat this three times a day for 2-3 days. Because of the potential for rebound congestion I don’t recommend using the Afrin for more than three days in a row. If not contraindicated I will probably put you on a oral antibiotic and steroid as well. You can continue the Saline and Steroid spray indefinitely. I advocate using 2-3 sprays in each nostril (spraying up and out) twice a day for two weeks and then once a day for three months. I may also advocate Bacroban ointment to be applied to the nostrils every morning and evening.

A Medrol Dose Pack is often sufficient.  Interestingly, if you were to take all the pills in a Medrol Dose Pack at one time, it would be like taking 105 mg of Prednisone.  You would be a bit wired and hungary, but you would live.