Appropriate antibiotic use in treating respiratory tract infections

The emergence of drug-resistant pathogens, especially Streptococcus pneumoniae and Haemophilus influenzae, has complicated empiric treatment of both upper and lower respiratory tract infections. Clinicians are now forced to reevaluate their choices of first-line antibiotics. Although some bacterial respiratory infections may resolve spontaneously, the use of antibiotics has demonstrated a faster resolution of symptoms and prevention of sequelae and recurrences, thereby improving the patient's quality of life and ability to function. Therefore, it is recommended that all diagnosed bacterial respiratory infections be treated with an antibiotic. Factors that clinicians need to consider in prescribing an antibiotic are the predominant causative pathogens, rates of pathogen resistance, patient history, the bacteriologic and clinical efficacy, safety profile, dosing regimen, and cost effectiveness of available antibiotic choices.