Fast Five Quiz: Upper Respiratory Tract Infections

Michael Stuart Bronze, MD


January 22, 2021

According to the CDC, these are the recommended guidelines for antibiotic use in adults with URI:

  • The overwhelming majority of acute rhinosinusitis cases are viral, and antibiotics are not guaranteed to help, even if the causative agent is bacterial. Amoxicillin or amoxicillin/clavulanate is recommended as first-line therapy for adults with acute bacterial rhinosinusitis. Macrolide antibiotics such as azithromycin are not recommended due to high levels of S pneumoniae antibiotic resistance.

  • Antibiotic treatment is not recommended for adults with pharyngitis who have negative rapid antigen detection test results. Amoxicillin and penicillin V remain first-line therapy due to their reliable antibiotic activity against group A streptococcal infections. The recommended treatment course for all oral beta-lactam antibiotics is 10 days. For patients who are allergic to penicillin, cephalexin, cefadroxil, clindamycin, or macrolide antibiotics are recommended.

  • NSAIDs can be given to relieve symptoms in individuals with nonspecific URIs. Decongestants (pseudoephedrine and phenylephrine) combined with a first-generation antihistamine may provide short-term symptom relief of nasal symptoms and cough. Evidence is lacking to support antihistamines (as monotherapy), opioids, intranasal corticosteroids, and nasal saline irrigation as effective treatments for cold symptom relief.

Read more about the treatment of URIs.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases article Upper Respiratory Tract Infection.

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