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Analyzing Annals: Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults
Antibiotics are often inappropriately prescribed for patients with acute respiratory tract infection. In this article, the American College of Physicians and the Centers for Disease Control and Prevention present best practice advice for antibiotic use in healthy adults presenting with ARTI. Review the Annals report, 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, and consider the following:
- What are the circumstances in which antibiotics should be considered for the treatment of an acute respiratory tract infection? Review the 4 high-value care advice statements and the information in Table 1. What are the benefits of antibiotic use for acute bronchitis, pharyngitis, acute rhinosinusitis, and the common cold? What are the harms?
- When is testing for group A streptococcus appropriate for a patient with acute pharyngitis? What circumstances should prompt consideration of a more severe infection (e.g., an abscess, epiglottitis, or Lemeirre syndrome)?
- We have all heard many times that antibiotics are inappropriate for most patients with acute respiratory tract infections. Why do antibiotics continue to be prescribed inappropriately so often?
- Role-play the evaluation of patients with acute respiratory tract infections whose history and risk factors indicate that antibiotics are not indicated. How do you respond when the patient requests an antibiotic (“But a Z-pack always makes me feel better” or “If I don't get an antibiotic, this always goes down to my chest”)?