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Principles of Appropriate Antibiotic Use for Treatment of Nonspecific Upper Respiratory Tract Infections in Adults
- Vincenza Snow, MD;
- Christel Mottur-Pilson, PhD;
- Ralph Gonzales, MD, MSPH; and
- for the American College of Physicians–American Society of Internal Medicine*
- Respiratory tract infections
- Antibiotics
- Drug resistance, microbial
- Practice guidelines
- Streptococcus pneumoniae
CLINICAL PRACTICE GUIDELINE, PART 1
The number of antibiotic-resistant organisms has increased in the past decade. The causes for this phenomenon include widespread use of antibiotics in agriculture, increased use of antibiotics in pediatric patients, and excessive use of antibiotics in adults. The majority of antibiotics prescribed to adults seen in U.S. ambulatory practice are for acute respiratory tract infections, in particular acute sinusitis; acute pharyngitis; acute bronchitis; and nonspecific upper respiratory tract infections, including the common cold. Because decreasing community use of antibiotics is an important strategy for combating the increase in community-acquired antibiotic-resistant infections, the American College of Physicians–American Society of Internal Medicine made this issue a priority for guideline development and physician education.
The four guidelines in this issue are based on a series of papers discussing the appropriate use of antibiotics in upper respiratory tract infections. The series, sponsored by the Centers for Disease Control and Prevention, was developed by a panel of physicians representing internal medicine, family medicine, emergency medicine, and infectious diseases. For more detailed information about the background and methods of development of these papers, please refer to “Principles of Appropriate Antibiotic Use for Acute Respiratory Tract Infections in Adults: Background, Specific Aims, and Methods” in this issue (see pages 479-486).
The goal of the guidelines and accompanying papers is to provide clinicians with practical strategies for limiting antibiotic use to the patients who are most likely to benefit from it. These guidelines are targeted to primary care physicians and subspecialists. They apply only to immunocompetent adults with no important comorbid conditions, such as pulmonary or cardiac disease. The targeted clinical setting is outpatient practice, but the guidelines can also apply to residents of long-term care facilities (if they fit the patient inclusion …
