Treatment of COMMON RESPIRATORY INFECTIONS: The ANTIBIOTIC DILEMMA

Respiratory tract infections are one of the commonest reasons for a visit to a family physician, and given time constraints and perceived patient expectations many consultations will end with an antibiotic prescription. Antibiotic resistance among the respiratory tract pathogens is clinically significant and increasing rapidly, and clinicians treating outpatients with respiratory tract infections need to grapple with the issue of whether or not an antibiotic should be prescribed (Fig. 1). A recent study from the United States gives insight into the manner in which clinicians respond to these issues. The study reviewed the treatment of more than 24,000 adults presenting with nonspecific respiratory tract infections and revealed that 63% received a prescription for an oral antibiotic. Importantly, the study excluded patients with chronic bronchitis, asthma or chronic obstructive pulmonary disease (COPD), and concluded that interventions are needed to reduce antibiotic prescribing to limit the progression of antibiotic resistance.