Summaries for Patients are a service provided by Annals and the ACP Center for Patient Partnership in Healthcare to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
This article was published at www.annals.org on 19 January 2016.
The full report is titled “Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention.” The authors are A.M. Harris, L.A. Hicks, and A. Qaseem, for the High Value Care Task Force of the American College of Physicians and for the Centers for Disease Control and Prevention.
Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016;164:I-34. doi: 10.7326/P16-9009
Download citation file:
Published: Ann Intern Med. 2016;164(6):I-34.
Published at www.annals.org on 19 January 2016
Acute respiratory tract infections (ARTIs) are common in adults. ARTIs include bronchitis, sinus infections, sore throat, and the common cold. Most are caused by a virus, not by bacteria.
Antibiotics are medicines used to treat illnesses that are caused by bacteria, such as strep throat (medical name: group A streptococcal pharyngitis) or pneumonia. Antibiotics will not work for illnesses caused by viruses, such as the common cold. Antibiotics can cause harm when they are not used the right way. These harms can include:
•Side effects: These can be mild, such as upset stomach, diarrhea, or skin rash. However, in some cases they can be very serious and even life-threatening.
•High costs: Prescriptions that are not needed increase patients' out-of-pocket costs. It is estimated that 50% of antibiotic prescriptions are not needed, totaling more than $3 billion in wasted spending.
•Antibiotic resistance: When antibiotics are used when they are not needed, germs and bacteria can become resistant to them. This means that common antibiotics will not be able to treat certain illnesses. Antibiotic-resistant bacteria cause more serious illnesses that are harder to cure and can be life-threatening.
Because antibiotics have often been used when not needed, many patients expect to receive antibiotics for ARTIs and believe that they need them to feel better. In other cases, clinicians may prescribe antibiotics right away, rather than waiting or testing to see if they are needed.
The authors looked at research and clinical guidelines related to antibiotic use for ARTIs. This information was used to develop advice for clinicians and patients.
Reducing unneeded antibiotic prescribing will improve care, lower costs, and help to stop antibiotic resistance. In most patients, symptoms get better in 1 to 2 weeks. Coughs can sometimes last up to 6 weeks. The ACP recommends the following:
•Clinicians should not prescribe antibiotics for patients with bronchitis. Antibiotics should only be used if patients have pneumonia.
•Clinicians should test patients with symptoms that could be strep throat. Because symptoms alone are not reliable, antibiotics should only be prescribed when testing confirms strep throat. Other sore throat infections do not need antibiotics.
•Clinicians should not prescribe antibiotics for sinus infections unless patients have severe symptoms or symptoms that last more than 10 days. Patients whose symptoms improve but eventually get worse may also need antibiotics.
•Clinicians should not prescribe antibiotics for patients with the common cold.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Infectious Disease, Pulmonary/Critical Care.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only