The CDC released guidelines for use of antibiotics in certain respiratory conditions. In light of the emerging number of resistant bacteria, it is imperative that healthcare providers be judicious in prescribing antibiotics for acute respiratory infections and strep pharyngitis.
Aaron M. Harris, MD, epidemiologist at the CDC declared "Providers should apply strict criteria…to determine when antibiotics are needed."
Harris also stated, "Except for confirmed bacterial infections like streptococcal pharyngitis or acute bacterial sinusitis, antibiotics should not routinely be used to treat healthy adults with acute respiratory tract infections at outpatient clinics…Treatments to relieve symptoms are available and can be used to reduce discomfort."
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The American College of Physicians task force desires to decrease the number of deaths that result yearly from drug resistant bacteria. This number of deaths increases yearly and was over 23 thousand according to data published by Medscape News.
Dr. Harris informs that, "Overuse of antibiotics contributes to the spread of antibiotic resistance, which has led to approximately two million people developing antibiotic-resistant illnesses."
The new guidelines have four major areas of focus:
Bronchitis Strep throat and Pneumonia
Clinicians should refrain from prescribing antibiotics to patients diagnosed with bronchitis unless bacterial pneumonia is confirmed in addition.
Only confirmed cases of strep pharyngitis should be prescribed antibiotics.
Prescribers should identify the specific bacterial organism prior to prescribing antibiotics (if possible).
In the past, antibiotics were prescribed to treat sinus infections. The new recommendations are to withhold the antibiotic therapy and use symptomatic treatment for majority of sinus infections.
Antibiotics should only be prescribed to patients who have any of the following: symptoms present for greater than ten days, a fever >102.2, in cases where symptoms are present for more than 10 days, severe facial pain with nasal discharge for greater than three days, or if the illness began to improve and then worsened.
The Common Cold
Antibiotics should not be prescribed.
Over the Counter medications should be used for symptom management. Acetaminophen, aspirin, cough medications, and rest are recommended.
See a doctor if symptoms persist for more than two weeks.
Keeping up to date on the resistance patterns in your geographical area can greatly assist in prescribing a narrower spectrum drug that will eliminate the bacteria. There are many resources available in the form of smart phone apps and Google Apps for computers. CDC alerts are available as well.
Healthcare providers have a part of the answer to the resistance epidemic in their hands......and it is not in the form of a script pad. Educating the patient on treatment with symptom management and when an antibiotic is needed and when they will not work is an essential part of the plan of care.
Ann Intern Med. Published online January 19, 2016. Full Text Here