Notes

ACP & CDC Offer Advice for Use of Antibiotics for Acute Respiratory Infections

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD


The American College of Physicians and the CDC have published a set of recommendations on the appropriate use of antibiotics for acute respiratory tract infection.


The recommendations, published in the Annals of Internal Medicine, include the following:

•Bronchitis: Clinicians shouldn't order tests or start antibiotics unless they suspect pneumonia.
•Group A streptococcal pharyngitis: Clinicians should conduct a rapid antigen detection test and/or culture for group A Streptococcus in symptomatic patients. Only patients with confirmed streptococcal pharyngitis should receive antibiotics.
•Acute rhinosinusitis: Clinicians should prescribe antibiotics only in patients with symptoms that have lasted over 10 days; with severe symptom onset or high fever and purulent nasal discharge or facial pain that has lasted for 3 days or more; or with worsening symptoms after a viral illness that was improving.
•Common cold: Antibiotics shouldn't be prescribed.


The groups also provide a set of talking points for clinicians when discussing antibiotic use with patients who have an acute respiratory tract infection.