Treatment Guidelines for Upper Respiratory Tract Infections

One of the initial activities of CDC's Get Smart campaign was the development and distribution of principles for appropriate antibiotic use for pediatric upper respiratory tract infections. These guidelines were developed in collaboration with the American Academy of Pediatrics and members of the American Academy of Family Physicians. CDC then collaborated with members of the American Academy of Family Physicians, American College of Physicians, Infectious Diseases Society of America, and the America College of Emergency Physicians to develop principles of appropriate antibiotic use for adult respiratory tract infections. The pediatric and adult guidelines provide a definition of appropriate prescribing and have been distributed to numerous state and local health departments, health plans, physician groups, and others.

One page academic detailing sheets and Publications

Adult Treatment Guidelines:
Upper Respiratory Tract Infections

(For Clinicians)

One Page Adult Academic Detailing Sheets

These sheets are useful for conducting small group or one-on-one educational sessions. They have been used by many programs around the country seeking to change clinician prescribing behavior.

Adult Appropriate Antibiotic Use Summary

Physician Information Sheet (Adults)

Target Audience: Clinicians, Health Educators, Infection Control Professionals, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Pharmacists

CDC recommendations for promoting prudent antibiotic use in adults.

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[30 KB, 1 page]

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Nonspecific Upper Respiratory Tract Infection

Physician Information Sheet (Adults)

Target Audience: Clinicians, Health Educators, Infection Control Professionals, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Pharmacists

Principles of appropriate antibiotic use apply to the diagnosis and treatment of acute upper respiratory tract infection (common cold) in otherwise healthy adults.

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[131 KB, 1 page]

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Acute Pharyngitis in Adults

Physician Information Sheet (Adults)

Target Audience: Clinicians, Health Educators, Infection Control Professionals, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Pharmacists

Principles apply to the diagnosis and treatment of Group A ß-hemolytic streptococcal (GABHS) pharyngitis in otherwise healthy adults.

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[131 KB, 1 page]

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Acute Bacterial Rhinosinusitis

Physician Information Sheet (Adults)

Target Audience: Clinicians, Health Educators, Infection Control Professionals, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Pharmacists

Principles of appropriate antibiotic use for acute rhinosinusitis apply to the diagnosis and treatment of acute maxillary and ethmoid rhinosinusitis in otherwise healthy adults.

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[35 KB, 1 page]

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Acute Cough Illness (Acute Bronchitis)

Physician Information Sheet (Adults)

Target Audience: Clinicians, Health Educators, Infection Control Professionals, Nurse Practitioners, Nurses, Physician Assistants, Physicians, Pharmacists

Principles of appropriate antibiotic use apply to the diagnosis and treatment of uncomplicated acute bronchitis in otherwise healthy adults.

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[127 KB, 1 page]

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Publications: Principles for Adult Appropriate Antibiotic Use

Principles of Appropriate Antibiotic Use for Treatment of Acute Respiratory Tract Infections in Adults: Background, Specific Aims, and Methods
Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA. Annals of Internal Medicine. March 20, 2001;134:479-486.
The guidelines in this issue provide evidence-based recommendations for evaluation and treatment of adults with acute respiratory illnesses. This paper describes the background and specific aims of and methods used to develop these principles. The goal of the principles is to provide clinicians with practical strategies for limiting antibiotic use to the patients who are most likely to benefit from it.
Abstract
Principles of Appropriate Antibiotic Use for Treatment of Nonspecific Upper Respiratory Tract Infections in Adults: Background
Gonzales R, Bartlett JG, Besser RE, Hickner JM, Hoffman JR, Sande MA. Annals of Internal Medicine. March 20, 2001;134:490-494
The goals of this paper are to provide evidence-based recommendations for when to apply the diagnosis of upper respiratory tract infection and when to consider antibiotic treatment of adults with an uncomplicated upper respiratory tract infection.
Abstract
Principles of Appropriate Antibiotic Use for Acute Rhinosinusitis in Adults: Background
Hickner JM, Bartlett JG, Besser RE, Gonzales R, Hoffman JR, Sande MA. Annals of Internal Medicine. March 20, 2001;134:498-505.
This paper argues for a conservative approach to use of antibiotics in patients with sinusitis-like symptoms, consistent with efforts to reduce antibiotic use for respiratory infections in ambulatory patients.
Abstract
Principles of Appropriate Antibiotic Use for Acute Pharyngitis in Adults: Background
Cooper RJ, Hoffman JR, Bartlett JG, Besser RE, Gonzales R, Hickner JM, Sande MA. Annals of Internal Medicine. March 20, 2001;134:509-517.
Most immunocompetent adults with sore throat have acute infectious pharyngitis. Widespread antibiotic use in such patients has been based on an effort to treat bacterial (particularly streptococcal) pharyngitis. This paper addresses the rational treatment of nongonococcal, nondiphtherial acute pharyngitis in healthy adults.
Abstract
Principles of Appropriate Antibiotic Use for Treatment of Uncomplicated Acute Bronchitis: Background
Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA. Annals of Internal Medicine. March 20, 2001;134:521-529.
Most cases of acute bronchitis occur in otherwise healthy adults, in whom this acute cough illness can be called "uncomplicated acute bronchitis." This paper discusses use of antibiotics in these patients.
Abstract
Diagnosis and Management of Cough: ACCP Evidence-Based Clinical Practice Guidelines
Irwin RS, Baumann MH, Bolser DC , et al: Diagnosis and management of cough: ACCP evidence-based clinical practice guidelines. Chest1S-292S, 2006.
These practice guidelines (1) more narrowly focuses the guidelines on the diagnosis and treatment of cough, the symptom, in adult and pediatric populations, and minimizes the discussion of cough as a defense mechanism; (2) improves on the rigor of the evidence-based review and describes the methodology in a separate section; (3) updates and expands, when appropriate, all previous sections; and (4) adds new sections with topics that were not previously covered.
Cough Guidelines on the Chest website
IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults
Chow AW, Benninger MS, Itzhak B, et al: Clin Infect Dis. 2012 Apr; 54(8):e72-e112. Epub 2012 Mar 20.
Evidence-based guidelines for the diagnosis and initial management of suspected acute bacterial rhinosinusitis in adults and children.
Rhinosinusitis Guidelines on the IDSA website
IDSA Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America
Shulman ST, Bisno AL, Clegg HW, et al: Clin Infect Dis; Epub 2012 Sep 9.
Evidence-based guidelines for the diagnosis and initial management of suspected acute bacterial rhinosinusitis in adults and children.
Pharyngitis Guidelines on the IDSA website

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