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Upper respiratory tract infections.

N Jain¹, R Lodha, S K Kabra

¹Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.

Indian Journal of Pediatrics

|February 13, 2002

Summary

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Most viral upper respiratory infections, like the common cold, do not require antibiotics. Bacterial sinusitis and Group A beta-hemolytic streptococcus (GABS) pharyngitis may need specific antibiotic treatments, such as amoxicillin or penicillin, respectively.

Area of Science:

Infectious Diseases
General Medicine
Pharmacology

Background:

Acute respiratory infections (ARIs) are a significant cause of hospital visits, with upper respiratory tract infections (URTIs) comprising the majority.
Viral infections are the primary cause of most URTIs, including the common cold, nasopharyngitis, pharyngitis, tonsillitis, and otitis media.

Purpose of the Study:

To review the appropriate use of antimicrobial agents in common upper respiratory tract infections.
To differentiate between viral and bacterial etiologies of sinusitis and pharyngitis and guide treatment decisions.

Main Methods:

Literature review of common upper respiratory tract infections and their causative agents.
Analysis of treatment guidelines for bacterial sinusitis and streptococcal pharyngitis.

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Main Results:

The majority of acute upper respiratory tract infections are viral and self-limiting, not requiring antibiotics.
Bacterial sinusitis, often associated with the common cold, may be treated with amoxicillin, with alternatives like cefaclor or cephalexin for recurrent cases.
Acute pharyngitis is typically viral; however, Group A beta-hemolytic streptococcus (GABS) accounts for approximately 15% and requires penicillin or alternative antibiotics to prevent complications like acute rheumatic fever.

Conclusions:

Antibiotic stewardship is crucial for managing upper respiratory tract infections, reserving antimicrobial agents for confirmed or suspected bacterial infections.
Prompt diagnosis and treatment of GABS pharyngitis with appropriate antibiotics can prevent serious sequelae.
Amoxicillin remains a primary choice for bacterial sinusitis, with specific alternatives for chronic or recurrent conditions.