Antibiotic Use in Respiratory Illness | October 2024 | News Flash

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October 31, 2024

ANTIBIOTIC USE IN RESPIRATORY ILLNESS

With the upcoming fall and winter respiratory season rapidly upon us, we would like to reiterate that antibiotics are often overprescribed for upper respiratory infections (URIs), bronchitis and pharyngitis, even though most are caused by viral infections, which do not respond to antibiotic treatment.  Generally, antibiotics are appropriate for sinusitis and strep pharyngitis or other bacterial illnesses.

Strep Pharyngitis:

  • Healthcare providers can use a positive rapid antigen detection test (RADT) or throat culture as confirmation of group A strep pharyngitis. Throat culture after a negative RADT isn't routinely indicated.
  • Antibiotics should only be prescribed if a RADT or culture is done on patients over the age of 3.

Acute Bronchitis / URI:

  • Routine antibiotic treatment of uncomplicated bronchitis / URI is not recommended, regardless of duration of cough and almost always gets better on its own—without antibiotics.
  • Providers evaluating patients with an acute cough illness or with presumptive diagnosis of uncomplicated acute bronchitis should focus on ruling out pneumonia.

Sinusitis:

  • Many do not require antibiotics, but if you do prescribe an antibiotic, suggest that the patient wait 2–3 days before filling the prescription to see if it gets better on its own.

 

In summary, we recommend using clinical judgement in each individual case, and to use this as a guideline for treatment or non-treatment.