ACP-ASIM Pressroom

ACP-ASIM Issues Four New Guidelines:
Antibiotics Not Needed For Most Respiratory Infections

PHILADELPHIA -- (March 20, 2001) The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) today released new guidelines saying that antibiotics are not needed for most respiratory tract infections. For most healthy adults, the best treatment for bronchitis, sinusitis, pharyngitis (sore throat) and non-specific upper respiratory tract infections are over-the-counter cold remedies and salt water gargles to relieve symptoms.

The four guidelines, four background papers on upper respiratory tract infections and an introductory essay are in today's Annals of Internal Medicine, the peer-reviewed journal published by ACP-ASIM.

"ACP-ASIM is concerned about the growing threat of antibiotic-resistant diseases," says Sandra Adamson Fryhofer, MD, the society's president. "Up to 75 percent of antibiotics prescribed each year are associated with treating upper respiratory tract infections. Unfortunately, most of these prescriptions are unnecessary. As a professional organization representing internists who treat the majority of adult patients, we decided that our best contribution to reducing overuse and inappropriate use of antibiotics is to develop guidelines for the management of these common infections."

The College's new guidelines are based on four background papers of principles for appropriate antibiotic use in upper respiratory tract infections developed by a Centers for Disease Control (CDC) panel with representatives from ACP-ASIM, the American Academy of Family Physicians (AAFP) and the Infectious Diseases Society of America (IDSA). Some or all of the principles in the papers have been endorsed by the CDC, ACP-ASIM, AAFP and IDSA.

To expedite doctor-patient discussions about appropriate use of antibiotics and the dangers of antibiotic resistance, ACP-ASIM has developed a patient education brochure that is available by calling 1-800-523-1546, ext. 2600. The information is also available on an ACP-ASIM Web site: www.doctorsforadults.com.

"Patients should not think they are getting poor treatment if their doctors don't prescribe antibiotics," says Vincenza Snow, MD, senior medical associate at ACP-ASIM. "Most colds and other respiratory tract infections are caused by viruses, and antibiotics don't affect viruses. Try nasal sprays, decongestants, cough drops and gargles to relieve symptoms before you call the doctor." Snow notes that ACP-ASIM does not endorse any over-the-counter products or pharmaceuticals. "Finally, don't expect the symptoms to clear up right away," Snow says. "Colds usually last for up to two weeks."

The guidelines are for healthy adults. They are not intended for people over age 65 or with other long-term medical conditions such as diabetes, heart or lung problems, Snow says.

ACP-ASIM is a professional organization representing 115,000 internists, doctors for adults, and is the second largest medical organization in the United States. It has been issuing evidence-based clinical practice guidelines for 20 years.

"The CDC is delighted to work with ACP-ASIM, AAFP and IDSA on efforts to reduce overuse of antibiotics," says Richard E. Besser, MD, director of the CDC campaign to promote appropriate antibiotic use for respiratory infections. "A key element in the CDC's strategy to reduce overuse of antibiotics is to have reliable, evidence-based practice principles for physicians. The guidelines for upper respiratory tract infections provide these. We also rely on the experience and knowledge of professional organizations such as ACP-ASIM and AAFP to help get the principles into office practices and doctor-patient discussions."

Notes to Editors:

Embargoed copies of these papers are available by calling Penelope Fuller at 215-351-2656 or 1-800-523-1546, ext. 2656.

The ACP-ASIM patient education brochure on antibiotic resistance is available at http://www/doctorsforadults.com or can be obtained by calling 1-800-523-1546, ext. 2600.

The following people are available for interview by calling Susan Anderson at 215-351-2653 or 800-523-1546, ext. 2653.

  • Sandra A. Fryhofer, ACP-ASIM president (Atlanta)
  • Herbert Waxman, MD, ACP-ASIM senior vice president for education (Philadelphia)
  • Vincenza Snow, MD, senior medical associate at ACP-ASIM, an author of the guidelines (Philadelphia)
  • David Dale, MD, chairman of ACP-ASIM Clinical Efficacy Assessment Committee (Seattle)
  • Preston Winters, MD, member ACP-ASIM Clinical Efficacy Assessment Committee (New York City)

The following people are also available for interview:

  • Ralph Gonzales, MD, MSPH, University of Colorado Health Sciences Center, coordinator of CDC background principles papers (Denver, 303-372-9084)
  • Richard E. Besser, MD, medical epidemiologist, director, CDC Campaign to Promote Appropriate Antibiotic Use, Respiratory Diseases Branch, National Center for Infectious Diseases, CDC (Atlanta)