Antibiotics For Lower Respiratory Infection

Indications For Antibiotic Therapy

Given the risks of GAS, especially ARF, and because antibiotics have not proved effective in the management of nonstreptococcal pharyngitis, antibiotic treatment is justified only in patients with GAS-pharyngitis .

The streptococcal origin of pharyngitis cannot be determined by any clinical signs or scores with adequate positive and/or negative predictive value. Only microbiological tests are reliable to confirm the diagnosis of GAS-pharyngitis . In clinical practice, culture of pharyngeal specimens is not a routine procedure. Rapid antigen tests carried out by physicians are recommended. Their specificity is similar to that of cultures and their sensitivity is close to 90%. In children below 3years of age, RAT is usually not performed as GAS is rarely involved. The following approach is recommended:

Practical approach to treating pharyngitis.

How Long Do Upper Respiratory Infections Last

Upper respiratory infections typically last one to two weeks. Most of the time, they go away on their own. Over-the-counter pain medications can help you feel better. Make sure you drink plenty of fluids to stay hydrated.

If your symptoms last longer than two weeks, talk to your healthcare provider. You may have another condition that is causing the symptoms, such as pneumonia or bronchitis.

What Is The Fastest Way To Get Rid Of A Upper Respiratory Infection

Some home remedies to help the cold pass through your body a little faster are:

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What Antibiotics Can Help Treat Respiratory Infections

The over-prescription of antibiotics, especially in outpatient settings in recent years, has led to increasing rates of antibiotic-resistant bacteria. Doctors today tend to be more judicious in their use of antibiotics when it comes to treating respiratory infections. Usually, an uncomplicated upper respiratory infection in an otherwise healthy adult doesn’t need antibiotic treatment.

Pneumonia, however, is often treated with antibiotics. Unlike most other respiratory tract infections, which are causes by viruses, pneumonia is usually caused by bacteria. Many factors help a doctor decide which antibiotic to prescribe. Your age, your symptoms, the severity of the infection, your allergies and any underlying medical conditions all come into play. Also, doctors would consider which bacteria is the cause of your pneumonia, even though they might start you on an antibiotic that has a wide range of effectiveness, until they find out for certain. Usually, pneumonia is caused by streptococcus pneumoniae bacteria or Mycoplasma pneumoniae.

If your pneumonia can be treated at home, as an outpatient, a doctor might prescribe you one of several classes of antibiotics: macrolides , tetracyclines , or fluoroquinolones . If your pneumonia requires hospitalization, in addition to the previous antibiotics, doctors might treat you with cephalosporins , penicillin , or vancomycin.

Antibiotics For Upper Respiratory Infections

When and Why You Might Need an Antibiotic for a Cold

Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.

Any given adult will get a cold at least a couple of times a yearusually in the fall and winter. Kids can get many colds, maybe even half a dozen or more a year. When you get a cold, also known as an upper respiratory tract infection, should you visit your healthcare provider and get antibiotics?

The truth is, antibiotics for respiratory infections arent going to make you feel better sooner, and they might even leave you with side effects that make you feel worse.

Colds are known medically as upper respiratory tract infections because theyre usually limited to the upper half of your respiratory systemthe nose, sinuses, upper throat, larynx, and pharynx. These infections dont, for example, include infections that affect your lungs, like pneumonia.

Steve Prezant/Getty

Upper respiratory tract infections are usually caused by viruses, like rhinovirus, coronavirus, or influenza, though rarely they are caused by bacteria. Bacteria that infect the upper respiratory tract are most often S. pyogenes , or sometimes H influenzae.

Antibiotics may be prescribed in a few different situations:

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Antibiotics For Respiratory Conditions

Viral exacerbations are not generally susceptible to conventional antibiotics however, this is often superseded by bacterial infection, at which stage the sputum becomes purulent and an antibiotic should be prescribed.

• Antibiotics are usually given over a short course, 5-7 days for exacerbations of COPD for example. In some diseases, research has shown it to be more beneficial to have longer courses, 14 days for example, in bronchiectasis.
• Prior to starting an antibiotic for an infection, ideally the choice of antibiotic should be tailored to the organism causing the infection. This can only be done by submitting a sputum specimen to a laboratory for bacterial and antibiotic sensitivity to be identified.
• Antibiotics may need to be started before results become available and lack of results should not prevent antibiotics being given.
• Often a broad spectrum antibiotic is given to cover the most likely bacteria. If patients fail to improve after several days, antibiotic choice may be changed on basis of laboratory results.

When choosing an antibiotic, minimising the risk of resistance is vital.

Other Upper Respiratory Tract Infections

There are a few other reasons you might be prescribed antibiotics for an upper respiratory infection. Strep throat, medically known as streptococcal pharyngitis, is a sore throat caused by infection by streptococcal bacteria. It is usually treated with penicillin.

Swelling of the epiglottis, the flap of tissue covering the windpipe, is potentially life-threatening, particularly in children ages 2 to 5 years. Called epiglottitis, this condition can impact breathing and is often caused by infection with the bacteria Haemophilus influenzae type b and should be treated with antibiotics, including a cephalosporin.

If the cold leads to an ear infection, antibiotics may help resolve it if pain relievers and decongestants dont do the trick. Antibiotic use guidelines for children with ear infections differ based on their age and symptoms.

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Treatment Of Common Lower Respiratory Tract Infections

• Keryn Christiansen

SummaryAntibiotics do not help the many lower respiratory infections which are caused by viruses. While acute bronchitis often does not require antibiotic therapy, antibiotics can be given to patients with acute exacerbations of chronic bronchitis. The indications for treatment are increased dyspnoea, and an increase in the volume or purulence of the sputum. The treatment of bacterial pneumonia is selected by considering the age of the patient, the severity of the illness and the presence of underlying disease. Amoxycillin and doxycycline are suitable for many of the lower respiratory tract infections seen in general practice.

IntroductionAn important consideration in the treatment of a patient with a lower respiratory tract infection is to decide if an antibiotic is required at all. Many infections are viral and symptomatic treatment only is required. If an antibiotic is required, the choice of drug will depend on the site of infection, the severity of illness, the age of the patient, the presence of any other underlying diseases, history of drug reactions and the likely compliance of the patient.

• increased dyspnoea
• increased sputum volume
• increased purulence

A meta-analysis2 also found a small, but statistically significant, improved outcome in the patients given antibiotics.

• the presence of underlying disease
• severity of illness.

AgeThis is important for two reasons.

Further reading

How Many Types Of Respiratory Diseases Are There

There are two types of respiratory diseases and disorders: infectious and chronic. Pulmonary infections are most commonly bacterial or viral. In the viral type, a pathogen replicates inside a cell and causes a disease, such as the flu. Chronic diseases, such as asthma, are persistent and long-lasting.

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Is The Flu An Upper Respiratory Infection

Influenza, or the flu, isnt considered an upper respiratory infection. Thats because its systemic it affects more than one system in the body. It usually affects the upper and lower respiratory system. The cold and flu have similar symptoms.

The flu often comes along with symptoms such as achiness and a high temperature, in addition to upper respiratory symptoms like a cough and sore throat. See your healthcare provider if you think you may have the flu. You can take steps to prevent the flu, such as getting the flu vaccine every year.

Limitations Of The Study

There are several limitations of this study. The cross- sectional design of the study does not allow us to observe the susceptibility patterns over a period of time. We only have the access to culture reports, thus we are unable to crosscheck the information written on the reports with the patients and have to rely on the information given on the reports with lots of missing information that needs to be excluded from the study. A very few studies were available from Pakistan for a direct comparison of susceptibility patterns with our findings.

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Prevalence Of Bacterial Isolates

Gender wise prevalence of bacterial isolates are shown in Figure S1 & Table I. Out of total culture samples 169 were males and 90 were females . Only 42.7% males samples exhibited growth compared to 49% female samples . Besides, out of 259 selected culture samples, only 61.5% test reports had bacterial growth while 38.5% reports had no growth .

FIGURE S1TABLE I

Data regarding gender wise prevalence of bacterial isolates are summarized in Table I. Among the gram- positive category, S. aureus was the most frequent isolate followed by MRSA and MSSA . In gram-negative category, P. aeruginosa was the most prevalent isolate followed by Klebsiella and E. coli . In both males and females, S. aureus was the most prevalent gram-positive isolate, while, P. aeruginosa , Klebsiella and E.coli were the most prevalent gram-negative isolates . However, the frequency of unknown isolates was much higher in gram-positive category in comparison to gram- negative category .

Indication For Antibiotic Therapy

Diagnosis is based on the symptomatic triad of fever, cough and respiratory distress of varying intensity. A distinction must be made between upper respiratory tract infections , which occur above the vocal cords, and in which the pulmonary auscultation is normal, and lower respiratory tract infections with cough and/or febrile polypnea. An initial clinical assessment is essential. This allows a distinction to be made between three possible clinical diagnoses: acute bronchiolitis, bronchitis and pneumonia. Bronchiolitis and bronchitis are very common , and are mainly of viral origin. Pneumonia is the expression of parenchymal involvement, therefore a bacterial origin should not be discounted.

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Managing Side Effects Of Antibiotics

While there are some cases in which you may be prescribed antibiotics for a common cold, these medications aren’t harmless. There are many side effects of antibiotics. Some are common, and others can be severe and potentially deadly.

• Allergic reactions
• Vaginal itching or yeast infections
• Nausea and vomiting

In a dataset from 2013 and 2014, adverse drug reactions caused 4 out of every 1,000 emergency room visits each year. The most common reason for the visit among children was an adverse reaction to antibiotics.

If you or your child is experiencing side effects from a prescribed antibiotic, make sure to tell your healthcare provider to be certain its nothing to worry about. Theyll also let you know if you should continue taking it or stop.

If youre taking antibiotics, here are a few things you can do to help ward off some side effects of antibiotics:

• Take a probiotic and eat fermented foods like yogurt and kefir.
• Limit sun exposure.
• Take your antibiotic as prescribed .
• Make sure to store it correctly .
• Ensure your healthcare provider knows about all other drugs and supplements youre taking.

What Are Common Respiratory Infections In Children

Respiratory infections are common in children. They happen more often when children are in daycare or school. Siblings can infect each other as well.

Its normal for kids to have up to six respiratory infections per year. And they can last up to two weeks. Most of the time, at-home remedies are enough to help your child feel better until the virus passes.

But if you have any concerns, see your childs healthcare provider. Certain infections require antibiotics. And if your child has worrying symptoms, such as a high fever or difficulty breathing, contact your provider or go to the emergency room.

Common respiratory infections among children include:

• Bronchiolitis, an infection that causes wheezing and coughing.
• Common cold, which usually involves a runny nose, cough and feeling run-down.
• Croup, which causes a hoarse cough that sounds like a seal.
• Ear infections, when bacteria infect the middle ear, causing pain.
• Pink eye, an eye infection, usually bacterial, that can cause a thick yellow discharge from the eye.
• Sinus infection, when viruses or bacteria infect and inflame the sinuses, causing pain.
• Sore throat, which can be viral or bacterial .

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Why Wont My Doctor Prescribe An Antibiotic For My Respiratory Infection Two Philadelphia Doctors Explain

Two Philadelphia doctors explain why antibiotics are no longer a go-to treatment for respiratory infections.

You are suffering with a runny nose, dry cough and low-grade fever. COVID testing is negative and you feel miserable. Nighttime cold relief medicine has helped you get some sleep, but the symptoms are lingering. You begin to think: Is it time to call the doctor for an antibiotic?

For many, this is a relatable scenario as we enter the cold and flu season. The routine may be a little different this season: Many clinicians are increasingly reluctant to prescribe antibiotics.

Antibiotics are drugs that treat bacterial infections and, when needed, are very effective. As it turns out, though, most upper respiratory infections are caused by viruses, for which antibiotics are unhelpful.

In fact, an estimated 50% of antibiotics prescribed for acute upper respiratory conditions are unnecessary and discordant with published guidelines, according to 2020 research published in Clinical Infectious Diseases, a medical journal associated with the Infectious Disease Society of America.

Still, many of our patients ask:

Why not just try the antibiotic anyway, especially if it seems to have worked in the past?

A Pharmacist Can Help With An Rti

A pharmacist can suggest treatments to help relieve your symptoms, such as and nasal sprays.

You can also buy cough medicines and throat lozenges, although there’s little evidence to show they help.

Some treatments contain paracetamol and ibuprofen.

If you’re taking these medicines separately, be careful not to take more than the recommended dose.

Certain treatments are not suitable for children, babies and pregnant women. Your pharmacist can advise you about the best treatment for you or your child.

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Exacerbations Of Chronic Bronchitis

Antibiotic therapy is often used in standard practice to treat exacerbations of chronic bronchitis, although the results of comparisons with placebo are contradictory. Exacerbations may be of bacterial, viral or noninfectious origin. If they are of bacterial origin, the benefit of antibiotic therapy is usually limited to patients suffering from an obstructive syndrome. The choice of the antibiotic is based on respiratory status and frequency of exacerbations. Other bronchial pathology should be identified and not mistaken for chronic bronchitis. They should be considered particularly in nonsmoking subjects. The present recommendation does not apply to either paroxysmal asthma or early chronic asthma , or to bronchiectasis. It may apply to late-stage chronic asthma, which presents considerable similarities with obstructive chronic bronchitis .

Values To The Elderly

1) Novel mechanism of action: nemonoxacin targets both topoisomerase IV and DNA gyrase, inhibiting DNA synthesis required to bacterial growth 2) Frequency of interactions: when the creatinine clearance is < 50 mL/min, the dosage of levofloxacin need to be adjusted, while nemonoxacin does not induce or inhibit CYP1A2, 2B6, 2C8, 2C9, C19, and 3A4 isozymes . No dosage adjustment is required for the elderly with impaired renal or hepatic function. 3) Side effects: unlike other commercially available fluoroquinolone agents , nemonoxacin does not exhibit evidences of phototoxicity, systemic active allergic reactions, significant hepatotoxicity, or severe CNS toxicity . 4) Dosing regimen: In a systemic review and meta-analysis of RCTs demonstrated that compared with 500 mg levofloxacin, nemonoxacin was more safe in cardiac conduction as measured by ECG QTc prolongation . In addition, a single-dose escalation study shows that there were no clinically significant changes in corrected QT in healthy Chinese volunteers , but the 750 mg dosage had a significantly higher risk of adverse effects than the 500 mg dosage, so the nemonoxacin 500 mg regimen may be adequate for the treatment of CAP . The oral dosage of nemonoxacin is 500 mg once daily while it is 100 mg twice daily for levofloxacin, making nemonoxacin a potential therapy for the elderly with LRTIs.

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When Antibiotics Are Appropriate

There are only a few situations in which your healthcare provider might prescribe antibiotics when youre dealing with a cold or flu. Usually, these are secondary bacterial infections caused by the cold or flu symptoms that cause issues in the sinuses or other structures of the upper respiratory system.

Antibiotics may be helpful if common cold symptoms last for more than 10 days, the Cochrane report found.