oa SA Pharmaceutical Journal - Treatment of common respiratory infections : the antibiotic dilemma : clinical
Antibiotic over-prescribing for acute upper respiratory tract infections (URTIs) is common and promotes antibiotic resistance. <br>In patients without underlying comorbidity the majority of URTIs will resolve spontaneously. <br>Patient satisfaction is related to the quality of the doctor-patient interaction rather than to receiving an antibiotic prescription. <br>Mucoid sputum or nasal discharge in itself is not an indication for an antibiotic. <br>Acute bacterial sinusitis can be diagnosed 7-10 days after an URTI, when nasal discharge becomes purulent and congestion persists, and is associated with facial pain worsened by bending forward. A history of sinus surgery or nasal polyps suggests that the patient may develop sinusitis more readily, especially if the discharge is bloodstained. <br>Patients with acute bronchitis and severe underlying lung disease or comorbidity may benefit from being treated early with an antibiotic to prevent pneumonia or to limit ongoing lung damage. <br>Sputum culture and sensitivity testing allow rational antibiotic selection for patients with structural lung disease (chronic bronchitis, emphysema and bronchiectasis) and recurrent respiratory tract infections.
Article metrics loading...