Antibiotic prescribing for upper respiratory-tract

infections in primary care

04 July 2003

http://www.health.gov.au/internet/main/publishing.nsf/content/cda-pubs-cdi-2003-cdi27suppl-
htm-cdi27supi.htm

The use and overuse of antibiotics in humans is a major contributor to the selection of antibiotic resistance
organisms. Recent evidence has shown that primary care prescribing selects for resistances of clinical
importance.

Results from the case studies and clinical audits are not comparable as some data are derived for hypothetical cases
whereas the clinical audits are self-reported with no assurance of standardised diagnostic labelling. However, they
do provide an insight into conditions for which GPs are more likely to prescribe antibiotics.

Overall, the antibiotic prescribing rate of around 50 per cent still allows room for improvement given that these
conditions are primarily viral or self-limiting in nature. Antibiotic prescribing for these conditions remains high and
with only moderate accord with national best practice guidelines. This is despite mounting evidence from systematic
reviews and meta-analyses that prescribing antibiotics does little to affect the course of many URTIs.

In conclusion, activities to address excessive antibiotic use need to include primary care settings as there is evidence
that the management of URTIs by this group is less than optimal. However, global arguments on developing
resistance can sometimes overwhelm quality issues surrounding antibiotic prescribing in this arena. Messages for
general practitioners must focus on the benefits and risk to the patient which can be applied in daily practice.
Promoting appropriate prescribing for URTIs will in itself contribute to reducing antibiotic resistance as there is
room for improvement in the current attitudes toward the management of these conditions.
International Journal of Current Pharmaceutical Research

ISSN- 0975-7066 Vol 5,

http://www.ijcpr.org/Issues/Vol5Issue3/712.pdf

UPPER RESPIRATORY TRACT INFECTIONS: AN OVERVIEW

Issue June 16, 2013

Upper respiratory tract infections (URTIs) have been regarded as the most frequent illnesses
affecting people worldwide. Several factors contributing to the widespread occurance of URTIs
may be attributed to breathing of contaminated air, direct contact with infected people,
overcrowded places, cigarette smoking and exposure to pathogens. URTIs can be characterized
by a group of disorders which include common cold, pharyngitis, tonsillitis, epiglottitis, sinusitis,
bronchitis, rhinitis, and nasopharyngitis, which significantly occurs in upper respiratory tract.
URTIs have been known to be caused by either viruses and bacterias; or combination of both.

Upper respiratory tract infections can be referred to a group of disorders like common cold,
pharyngitis, tonsilitis, sinusitis, bronchitis, and rhinitis. The cause these infections are viruses
like rhinovirus, coronavirus, parainfluenza virus, adenovirus, enterovirus and syncytial virus,
alongwith many bacterias like streptococcus pyrogens, mycoplasma pneumoniae, chlamydophila
pneumoniae, bordetella pertussis, streptococcus pneumoniae, and haemophilus influenzae. The
infection show various symptoms like coughing, sore throat, sneezing, difficulty in breathing,
runny nose, muscle pain, and weakness. A number of preventive measures have been suggested
which involve washing hands, avoid sharing of eatables, and taking seasonal vaccines. However,
various drugs like analgesics, antibiotics, and decongestants have been suggested to afford
beneficial effects but thorough study of novel therapeutic targets is demanded in order to
completely provide treatment and prevention of the patients presented with URTIs.
 Management of upper respiratory tract infections in
children
May 10, 2011
MF Cotton, MMed, PhD, DTM&H, Cert(ID), S Innes, MBBCh, MRCPCH, H Jaspan, MD, PhD, A Madide, FCPaed(SA),
and H Rabie, FCPaed(SA)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098742/

Upper respiratory tract infection (URTI) occurs commonly in both children and adults and is a
major cause of mild morbidity. It has a high cost to society, being responsible for absenteeism
from school and work and unnecessary medical care, and is occasionally associated with serious
sequelae. URTIs are usually caused by several families of virus; these are the rhinovirus,
coronavirus, parainfluenza, respiratory syncytial virus (RSV), adenovirus, human
metapneumovirus, influenza, enterovirus and the recently discovered bocavirus. This review will
mainly focus on the rhinovirus, where significant advances have been made in understanding the
epidemiology, natural history and relationship with other pathogens.

Knowledge of the natural history of rhinovirus infection and awareness of influenza, pertussis
and S. pyogenes will help the clinician to make clinically relevant decisions. There is already a
large body of evidence-based practical information that can easily be applied to diagnosis,
management and prevention.

Upper respiratory tract infection is reduced in physically fit and active adults

David C Nieman1, Dru A Henson2, Melanie D Austin1, Wei Sha3

Published Nov 1, 2010

http://bjsm.bmj.com/content/early/2010/09/30/bjsm.2010.077875

Limited data imply an inverse relationship between physical activity or fitness level and
the rates of upper respiratory tract infection (URTI). The purpose of this study was to
monitor URTI symptoms and severity in a heterogeneous group of community adults and
contrast across tertiles of physical activity and fitness levels while adjusting for potential
confounders
Results showed the number of days with URTI during the 12-week period was
significantly reduced, 43% in subjects reporting 5 days/week aerobic exercise compared
to those who were largely sedentary (1 day/week) and 46% when comparing subjects in
the high versus low fitness tertile. URTI severity and symptomatology were also reduced
32% to 41% between high and low aerobic activity and physical fitness tertiles. Thus, in
conclusion Perceived physical fitness and frequency of aerobic exercise are important
correlates of reduced days with URTI and severity of symptoms during the winter and
fall common cold seasons.