Principles of Judicious Use of Antimicrobial Agents for Pediatric Upper Respiratory Tract Infections

Author:

Dowell Scott F.1,Marcy S. Michael2,Phillips William R.3,Gerber Michael A.4,Schwartz Benjamin1

Affiliation:

1. From the Childhood and Respiratory Diseases Branch, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;

2. Kaiser Permanente, Panorama City, California;

3. Northwest Family Medicine, Seattle, Washington; and

4. Connecticut Children's Medical Center, Hartford, Connecticut.

Abstract

This article introduces a set of principles to define judicious antimicrobial use for five conditions that account for the majority of outpatient antimicrobial use in the United States. Data from the National Center for Health Statistics indicate that in recent years, approximately three fourths of all outpatient antibiotics have been prescribed for otitis media, sinusitis, bronchitis, pharyngitis, or nonspecific upper respiratory tract infection.1Antimicrobial drug use rates are highest for children1; therefore, the pediatric age group represents the focus for the present guidelines. The evidence-based principles presented here are focused on situations in which antimicrobial therapy could be curtailed without compromising patient care. They are not formulated as comprehensive management strategies. For most upper respiratory infections that require antimicrobial treatment, there are several appropriate oral agents from which to choose. Although the general principles of selecting narrow-spectrum agents with the fewest side effects and lowest cost are important, the principles that follow include few specific antibiotic selection recommendations.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference35 articles.

1. Trends in antimicrobial drug prescribing among office-based physicians in the United States.;McCaig;JAMA.,1995

2. Epidemiology of drug resistance: implications for a post-antimicrobial era.;Cohen;Science.,1992

3. The problem of resistant bacteria for the management of acute otitis media.;Barnett;Pediatr Clin North Am.,1995

4. The prevalence of drug-resistant Streptococcus pneumoniae in Atlanta.;Hofmann;N Engl J Med.,1995

5. Report of the ASM task force on antibiotic resistance.;Anonymous;Antimicrob Agents Chemother.,1995

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