[Consensus guidelines for the management of upper respiratory tract infections].

Abstract

Upper respiratory tract infections are the most common source of antibiotic prescriptions. Acute pharyngitis is caused mainly by viruses, viral cases can be distinguished from acute streptococcal pharyngitis using Centor clinical epidemiological criteria, by rapid antigen tests or throat culture. Treatment of choice for streptococcal infection is penicillin V given in two daily doses. In children, acute otitis media (AOM) is the infection for which antibiotics are most often prescribed. Predominant causative pathogens include Streptococcus pneumoniae, Haemophilus influenzae non-type b and Moraxella catarrhalis. Diagnosis is based on history, physical examination and otoscopic exam. Antibiotic treatment should be initiated promptly in all children<2 years of age, and in older children presenting bilateral AOM, otorrhoea, co-morbidities or severe illness. In Argentina, amoxicillin is the drug of choice given the low penicillin resistance rates for S. pneumoniae. In children who fail amoxicillin therapy, amoxicillin/clavulanate provides better coverage against beta-lactamase producing H. influenzae and M. catarrhalis. Rhinosinusitis is caused mainly by viruses, secondary bacterial complication occurs in less than 5% of cases. Diagnosis is based on physical examination and additional studies are not usually required. Acute bacterial sinusitis is caused by the same pathogens that cause AOM and amoxicillin is the drug of choice.

• Authors: Gustavo Lopardo, Aníbal Calmaggi, Liliana Clara, Gabriel Levy Hara, Analía Mykietiuk, Daniel Pryluka, Silvina Ruvinsky, Claudia Vujacich, Diego Yahni, Elizabeth Bogdanowicz, Manuel Klein, María J López Furst, Claudia Pensotti, María J Rial, Pablo Scapellato, Sociedad Argentina de Infectología, Sociedad Argentina de Pediatría, Sociedad Argentina de Medicina, Sociedad Argentina de Bacteriología, Micología y Parasitología Clínica
• Journal: Medicina (Medicina (B Aires)) Vol. 72 Issue 6 Pg. 484-94 ( 2012) ISSN: 0025-7680 [Print] Argentina
• Vernacular Title: Consenso sobre diagnóstico y tratamiento de infecciones de vías respiratorias altas.
• PMID: 23241293 (Publication Type: English Abstract, Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents

Topics

• Acute Disease
• Anti-Bacterial Agents (therapeutic use)
• Argentina
• Evidence-Based Medicine
• Humans
• Otitis Media (drug therapy)
• Pharyngitis (drug therapy)
• Rhinitis (drug therapy)
• Sinusitis (drug therapy)