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Guideline for the management of upper respiratory tract infections.
S Afr Med J. 2004 Jun; 94(6 Pt 2):475-83.SA

Abstract

INTRODUCTION

Inappropriate use of antibiotics for upper respiratory tract infections (URTIs), many of which are viral, adds to the burden of antibiotic resistance. Antibiotic resistance is increasing in Streptococcus pneumoniae, responsible for most cases of acute otitis media (AOM) and acute bacterial sinusitis (ABS).

METHOD

The Infectious Diseases Society of Southern Africa held a multidisciplinary meeting to draw up a national guideline for the management of URTIs. Background information reviewed included randomised controlled trials, existing URTI guidelines and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. The guideline is a consensus document based upon the opinions of the working group.

OUTPUT

Penicillin remains the drug of choice for tonsillopharyngitis. Single-dose parenteral administration of benzathine penicillin is effective, but many favour oral administration twice daily for 10 days. Amoxycillin remains the drug of choice for both AOM and ABS. A dose of 90 mg/ kg/day is recommended in general, which should be effective for pneumococci with high-level penicillin resistance (this is particularly likely in children < or = 2 years of age, in day-care attendees, in cases with prior AOM within the past 6 months, and in children who have received antibiotics within the last 3 months). Alternative antibiotic choices are given in the guideline with recommendations for their specific indications. These antibiotics include amoxycillin-clavulanate, some cephalosporins, the macrolide/azalide and ketolide groups of agents and the respiratory fluoroquinolones.

CONCLUSION

The guideline should assist rational antibiotic prescribing for URTIs. However, it should be updated when new information becomes available from randomised controlled trials and surveillance studies of local antibiotic susceptibility patterns.

Authors+Show Affiliations

Du Buisson, Bruinette and Partners, Ampath, Johannesburg.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Guideline
Journal Article
Practice Guideline
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15244257

Citation

Brink, A J., et al. "Guideline for the Management of Upper Respiratory Tract Infections." South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, vol. 94, no. 6 Pt 2, 2004, pp. 475-83.
Brink AJ, Cotton MF, Feldman C, et al. Guideline for the management of upper respiratory tract infections. S Afr Med J. 2004;94(6 Pt 2):475-83.
Brink, A. J., Cotton, M. F., Feldman, C., Geffen, L., Hendson, W., Hockman, M. H., Maartens, G., Madhi, S. A., Mutua-Mpungu, M., & Swingler, G. H. (2004). Guideline for the management of upper respiratory tract infections. South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 94(6 Pt 2), 475-83.
Brink AJ, et al. Guideline for the Management of Upper Respiratory Tract Infections. S Afr Med J. 2004;94(6 Pt 2):475-83. PubMed PMID: 15244257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Guideline for the management of upper respiratory tract infections. AU - Brink,A J, AU - Cotton,M F, AU - Feldman,C, AU - Geffen,L, AU - Hendson,W, AU - Hockman,M H, AU - Maartens,G, AU - Madhi,S A, AU - Mutua-Mpungu,M, AU - Swingler,G H, AU - ,, PY - 2004/7/13/pubmed PY - 2004/8/13/medline PY - 2004/7/13/entrez SP - 475 EP - 83 JF - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde JO - S Afr Med J VL - 94 IS - 6 Pt 2 N2 - INTRODUCTION: Inappropriate use of antibiotics for upper respiratory tract infections (URTIs), many of which are viral, adds to the burden of antibiotic resistance. Antibiotic resistance is increasing in Streptococcus pneumoniae, responsible for most cases of acute otitis media (AOM) and acute bacterial sinusitis (ABS). METHOD: The Infectious Diseases Society of Southern Africa held a multidisciplinary meeting to draw up a national guideline for the management of URTIs. Background information reviewed included randomised controlled trials, existing URTI guidelines and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. The guideline is a consensus document based upon the opinions of the working group. OUTPUT: Penicillin remains the drug of choice for tonsillopharyngitis. Single-dose parenteral administration of benzathine penicillin is effective, but many favour oral administration twice daily for 10 days. Amoxycillin remains the drug of choice for both AOM and ABS. A dose of 90 mg/ kg/day is recommended in general, which should be effective for pneumococci with high-level penicillin resistance (this is particularly likely in children < or = 2 years of age, in day-care attendees, in cases with prior AOM within the past 6 months, and in children who have received antibiotics within the last 3 months). Alternative antibiotic choices are given in the guideline with recommendations for their specific indications. These antibiotics include amoxycillin-clavulanate, some cephalosporins, the macrolide/azalide and ketolide groups of agents and the respiratory fluoroquinolones. CONCLUSION: The guideline should assist rational antibiotic prescribing for URTIs. However, it should be updated when new information becomes available from randomised controlled trials and surveillance studies of local antibiotic susceptibility patterns. SN - 0256-9574 UR - https://www.unboundmedicine.com/medline/citation/15244257/Guideline_for_the_management_of_upper_respiratory_tract_infections_ L2 - https://medlineplus.gov/antibiotics.html DB - PRIME DP - Unbound Medicine ER -