New Guidelines Detail Antibiotic Use for Respiratory Infections

The American College of Physicians and the CDC has published recommendations for the appropriate use of antibiotics in the treatment of acute respiratory tract infections.

Acute respiratory tract infection (ARTI) is currently the most common reason for antibiotic use among adults, and antibiotics for ARTI are often inappropriately prescribed.

RELATED CONTENT
Dose Counters Reduce Respiratory-Related ER Visits
New Guidelines Discourage Antibiotic Use in Sinus Infections

In order to present the best practices for antibiotic use in adults with ARTI, researchers conducted a narrative literature review of evidence from studies of acute bronchitis, respiratory tract infections, pharyngitis, rhinosinusitis, and the common cold.

The recommendations include the following:

  1. Testing should not be performed and antibiotics should not be prescribed in patients with bronchitis unless pneumonia is suspected.
  2. Rapid antigen detection or culture for group A streptococcus should be used to test patients with symptoms suggesting streptococcal pharyngitis. Antibiotics should be given only if streptococcal pharyngitis is confirmed.
  3. In patients with acute rhinosinusitis and persistent symptoms of more than 10 days, onset of severe symptoms, or high fever lasting 3 consecutive days, antibiotic use is appropriate.
  4. Antibiotic prescription is not appropriate in patients with the common cold.

“Reducing inappropriate antibiotic prescribing will improve quality of care, decrease health care costs, and preserve the effectiveness of antibiotics,” they concluded.

—Michael Potts

Reference:

Harris AM, Hicks LA, Qaseem A, et al. Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the american college of physicians and the centers for disease control and prevention. Ann Intern Med. 2016 January 19 [epub ahead of print]. doi:10.7326/M15-1840.