02/22/2019

Pulmonary Care: Respiratory Tract Infection Treatment With Antibiotics

By Artemio J. Mendoza, MD, Wentworth Health Partners Summit Infectious Disease

It's cold and flu season, and the Emergency Department and physician offices are full!  In fact, upper respiratory tract infections (URIs) constitute the majority of emergency room and outpatient doctor visits.

Most URIs can be treated conservatively with supportive care and symptomatic relief. As physicians caring for patients with URIs, it is imperative that we focus on optimal prescribing for URIs. The overuse of antibiotics is becoming a public health concern – leading to increased health care costs, the development of antibiotic resistance, and an increase in the rate of Clostridium difficile (c.diff”) infection.

Do I Need an Antibiotic?

URIs include bronchitis, the common cold, and sinusitis. Influenza is another acute respiratory illness, caused by the influenza A or B virus, affecting the upper and/or lower respiratory tracts. In all of these cases, the Infectious Diseases Society of America (IDSA) Guidelines do not recommend treatment with antibiotics. The URI guidelines recommend antimicrobial therapy only for cases of bacterial sinusitis.

Protect Yourself and Others

Antibiotics can’t treat the flu, but the flu vaccine is effective at preventing the illness. The United States Advisory Committee on Immunization Practices (ACIP) recommends an annual vaccination for everyone six months of age and older. This vaccination not only reduces the risk of influenza but also reduces the severity of illness, resulting in fewer missed days from work. In addition, widespread immunization of children appears to reduce influenza infections in unvaccinated children and adults of all ages.

Antimicrobial Stewardship Program

To promote judicious use of antimicrobial therapies, Wentworth-Douglass Hospital has implemented an Antimicrobial Stewardship Program to help ensure coordinated and consistent care for URIs. The primary goal is to optimize clinical outcomes for patients while minimizing unintended consequences of antibiotic use. The Antimicrobial Stewardship Program has been implemented in the Emergency Department and Express Care and will soon launch at our Wentworth Health Partners practices and Prompt Care.

To learn more about antibiotic prescribing and use, visit the Centers for Disease Control and Prevention's Antibiotic Use page.