ACP’s Antibiotics for Acute Respiratory Tract Infections paper
Embargoed until 5:00PM Eastern January 18, 2016
Embargoed for release until 5:00 p.m. Eastern Time on Monday, January 18, 2016
(1) Announcer: Respiratory tract infections are
the most common reason for outpatient antibiotic
prescriptions for adults. But an estimated 50
percent of prescriptions may be unnecessary or
inappropriate. The American College of Physicians
and the Centers for Disease Control and
Prevention offer advice for prescribing antibiotics
in a new paper.
Dr. Tanveer Mir, Chair, Board of
Regents, American College of
Physicians
(2) Dr. Tanveer Mir: Inappropriate use of
antibiotics for conditions like the common cold,
acute sinusitis, acute bronchitis or sore throat
leads to adverse drug reactions and antibiotic
resistance. This accounts for about two million
illnesses a year and twenty-three thousand
deaths, which is a public health hazard.
(3) Announcer: It is estimated that 5 to 25% of
patients who take antibiotics will have adverse
events, and about 1 in 1,000 will have a serious
adverse event.
(4) Dr. Tanveer Mir: Antibiotics are responsible for
the largest number of adverse drug reactions. One
in five emergency room visits are attributed to
antibiotic reactions.
(5) Announcer: ACP and the CDC advise doctors
to educate patients and reassure them that they
likely will get better without antibiotics.
(6) Dr. Tanveer Mir: Patient education is so
important because patients need to understand
that symptom-based therapies or simple over-thecounter medications can help them get over the
common cold, get over a sinus infection or an
uncomplicated bronchitis.
ACP’s Antibiotics for Acute Respiratory Tract Infections paper
Embargoed until 5:00PM Eastern January 18, 2016
(7) Announcer: Another strategy is for doctors to
use a symptomatic prescription pad to provide
recommendations for management of symptoms
and offer the possibility of future antibiotic
treatment if the condition fails to improve. For
more information go to acponline.org.
Additional soundbites
Dr. Tanveer Mir
Chair, Board of Regents, American College of Physicians
Should physicians prescribe antibiotics for the common cold?
Physicians should not prescribe antibiotics for the common cold. If the period of recovery is
extended beyond two weeks then they may seek medical attention for that. Usually, symptombased therapies are the way to go for the common cold and to provide quick relief and
improvement in the medical conditions.
What should physicians do for uncomplicated bronchitis?
For uncomplicated bronchitis, physicians should not perform testing or prescribe antibiotics
unless pneumonia is suspected. Symptomatic relief with agents like antihistaminics, betaagonists, cough suppressants or even simple things like aspirin or acetaminophen may be the
way to go.
What should physicians do for sore throat?
For sore throat, physicians should recommend analgesic therapy like aspirin, acetaminophen,
non-steroidals, anti-inflammatory agents or throat lozenges to minimize pain.
What is the usual course for a sore throat and what should a physician do to reassure
patients about treatment with antibiotics?
Physicians should reassure patients that sore throat routinely lasts less than one week and
the use of antibiotics is not indicated. This leads to a larger number of side effects without
improving the condition.
What should physicians do for streptococcal pharyngitis?
When streptococcal pharyngitis is confirmed by rapid strep assay or by a culture that is
positive for group A streptococcus, antibiotics are indicated.
What should physicians do for sinus infection?
Uncomplicated sinus infection does not require antibiotics. The majority of patients with
uncomplicated sinus infections may suffer from side effects rather than benefit from antibiotic
therapy. Supportive management is indicated in the management of uncomplicated sinus
ACP’s Antibiotics for Acute Respiratory Tract Infections paper
Embargoed until 5:00PM Eastern January 18, 2016
infections.
When should physicians use antibiotic treatment for sinus infection?
Physicians should reserve antibiotics in the management of sinus infection when symptoms
are persistent for ten days or more or severe symptoms are noted for three days or more that
consist of high fever, facial pain, and nasal discharge. In addition, if a viral illness that was
improving initially continues for five days or more, antibiotics may be indicated as well.
What is a symptomatic prescription pad and how can it be used?
A symptomatic prescription pad can be used to provide recommendations for symptomatic
relief and the possibility of future antibiotic use if symptoms don’t improve.
So physicians can use simple terminologies like you know, the common cold, which makes it
very common and something that patients would accept. For bronchitis they can call it a
simple chest cold or they can call it a viral upper respiratory tract infection. Once we start
using those terminologies, patients are a little more comfortable and they better understand
what the condition is and the use of symptom-based therapies rather than antibiotics
becomes more acceptable to them.
Courtesy the American College of Physicians, publisher of Annals of Internal Medicine
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