Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults
High-Value Care Advice
- Clinicians should not perform testing or initiate antibiotic therapy in patients with bronchitis unless pneumonia is suspected.
- Clinicians should test patients with symptoms suggestive of group A streptococcal pharyngitis (for example, persistent fevers, anterior cervical adenitis, and tonsillopharyngeal exudates or other appropriate combination of symptoms) by rapid antigen detection test and/or culture for group A Streptococcus. Clinicians should treat patients with antibiotics only if they have confirmed streptococcal pharyngitis.
- Clinicians should reserve antibiotic treatment for acute rhinosinusitis for patients with persistent symptoms for more than 10 days, onset of severe symptoms or signs of high fever (>39 °C) and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving (double sickening).
- linicians should not prescribe antibiotics for patients with the common cold.
Recommendation Grading
Overview
Title
Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults
Authoring Organizations
American College of Physicians
Centers for Disease Control and Prevention
Publication Month/Year
March 1, 2016
Last Updated Month/Year
June 1, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
This article presents best practices for antibiotic use in healthy adults (those without chronic lung disease or immunocompromising conditions) presenting with acute respiratory tract infection
Target Patient Population
Patients with acute respiratory tract infection
Inclusion Criteria
Female, Male, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Management, Treatment
Diseases/Conditions (MeSH)
D001424 - Bacterial Infections, D012141 - Respiratory Tract Infections, D000073602 - Antimicrobial Stewardship
Keywords
pneumonia, antibiotic, upper respiratory infection (URTI), infections, Antibiotic Stewardship, Antibiotic Resistance