Antibiotic therapy of acute upper respiratory tract infections and otitis media in adults

Abstract

An estimated 50% of antibiotic prescriptions may be unjustified in the outpatient setting. Viruses are responsible for most acute respiratory tract infections. The viral infections are often self-limiting and only symptomatic treatment remains effective. Bacteria are involved in a small percentage of infections etiology in this area. In the case of a justified or documented suspicion of a bacterial infection, antibiotic therapy may be indicated. Based on the Polish „Recommendations for the management of non-hospital respiratory infections 2016”, the indications, the rules of choice, the appropriate dosing schedules and the therapy duration, in the most frequent upper respiratory tract infections in adults, have been presented. Implementation of the presented recommendations regarding our Polish epidemiological situation, will significantly reduce the tendency to abuse antibiotics, and thus will limit the spread of drug-resistant microorganisms.

Antibiotics use, urgency and beliefs about antibiotics in the case of acute pharyngitis

“…(2) absence of cough; (3) tender anterior cervical lymphadenopathy; and (4) tonsillar exudates [26]. Guided by the recommendations of the ACP, American Academy of Family Practice, and CDC, clinicians are advised to consider 2 primary management approaches: empirical treatment for individuals meeting 3-4 Centor criteria (referred to as the ACP empirical strategy), or conducting testing for patients exhibiting 2-3 criteria using a rapid antigen detection test (RADT), and subsequently administering antibiotics to those with a positive test result, or who meet all 4 criteria [27,28]. Nevertheless, according to Linder et al, in 66% of visits, clinicians followed no specific strategy.…”