Antibiotic Use in Acute Upper Respiratory Tract Infections

Area of Science:

• Infectious Diseases
• General Practice
• Antimicrobial Stewardship

Background:

• Upper respiratory tract infections (URTIs) lead to millions of physician visits yearly in the US.
• Viral pathogens cause the majority of acute URTIs.
• Inappropriate antibiotic prescribing for URTIs is a significant issue, leading to adverse events, antimicrobial resistance, and increased healthcare costs.

Purpose of the Study:

• To advocate for an evidence-based, judicious approach to antibiotic prescribing for URTIs.
• To differentiate conditions where antibiotics are indicated from those where they are not.
• To identify strategies for improving antibiotic prescribing appropriateness in primary care settings.

Main Methods:

• Review of current evidence and clinical guidelines for URTI management.
• Analysis of conditions commonly treated with antibiotics.
• Identification of best practices for antimicrobial stewardship in family medicine.

Main Results:

• Antibiotics are not indicated for viral infections like the common cold, influenza, COVID-19, and laryngitis.
• Evidence supports antibiotic use in specific bacterial infections including acute otitis media, group A streptococcal pharyngitis, and epiglottitis.
• A limited percentage of acute rhinosinusitis cases warrant antibiotic treatment.

Conclusions:

• Family physicians must adopt an evidence-based approach to antibiotic prescribing for URTIs.
• Judicious antibiotic use is essential to mitigate risks associated with inappropriate treatment.
• Implementing identified strategies can enhance appropriate antibiotic prescribing for URTIs.