Fast Five Quiz: Antibiotic Best Practices

Mary L. Windle, PharmD

Disclosures

September 11, 2019

According to recommendations by the CDC, routine treatment of uncomplicated acute bronchitis with antibiotics is not recommended, regardless of cough duration.

Options for symptomatic therapy include the following:

  • Cough suppressants

  • First-generation antihistamines

  • Decongestants

According to the CDC, watchful waiting is encouraged among adult patients with uncomplicated acute rhinosinusitis in an outpatient setting, provided that reliable follow-up is available. Amoxicillin or amoxicillin-clavulanate is the recommended first-line therapy, if antibiotics are prescribed. Macrolides, such as azithromycin, are not recommended owing to high levels of Streptococcus pneumoniae antibiotic resistance.

In adult patients with pharyngitis, antibiotic treatment is not recommended by the CDC for those with negative rapid antigen detection test results. First-line therapy remains amoxicillin and penicillin V. For penicillin-allergic patients, cephalexin, cefadroxil, clindamycin, or macrolides are recommended. Antibiotic resistance to azithromycin and clindamycin is increasing.

For acute uncomplicated cystitis in healthy adult nonpregnant, premenopausal women, nitrofurantoin, trimethoprim-sulfamethoxazole (if local resistance is < 20%), and fosfomycin are appropriate first-line agents, according to CDC guidelines. Fluoroquinolones (eg, ciprofloxacin) should be reserved for situations in which other agents are not appropriate.

Read more about the treatment of bronchitis.

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