Do not prescribe antibiotics for viral acute respiratory tract diseases (ear infections, sinusitis, pharyngitis, bronchitis)
Antibiotics are the most prescribed drugs in Italy, even in children, and the phenomenon of antibiotic resistance is a serious problem. The appropriate clinical management of upper respiratory tract infections provides for watchful waiting in most cases, on the basis of clinical, anamnestic and epidemiological criteria. The appropriate use of antibiotics is recommended only in cases with criteria of severity or that do not improve after watchful waiting. Avoiding the use of antibiotics in presumably viral infections, possibly also identified through the use of rapid tests – such as RAD in pharyngotonsillitis – and optimally treating bacterial infections (the first choice drug is unprotected amoxicillin) limits the emergence of resistant pathogens and the risk of adverse events from antibiotics.
1. Dawson-Hahn EE, Mickan S, Onakpoya I et al. Short-course versus long-course oral antibiotic treatment for infections treated in outpatient settings: a review of systematic reviews. Fam Pract 2017;34:511-19.
2. European Centre for Disease Prevention and Control. Antimicrobial consumption in the EU/EEA – Annual Epidemiological Report 2019. Stockholm: ECDC; 2020
3. Fraser H, Gallacher D, Achana F et al. Rapid antigen detection and molecular tests for group A streptococcal infections for acute sore throat: systematic reviews and economic evaluation. Health Technol Assess 2020;24:1-232.
4. Hu Y, Walley J, Chou R et al. Interventions to reduce childhood antibiotic prescribing for upper respiratory infections: systematic review and meta-analysis. J Epidemiol Community Health 2016;70:1162-70.
5. Mas-Dalmau G, Villanueva López C, Gorrotxategi Gorrotxategi P et al. Delayed antibiotic prescription for children with respiratory infections: a randomised trial. Pediatrics 2021;147: e20201323.
6. Spurling GK, Del Mar CB, Dooley L et al. Delayed antibiotic prescriptions for respiratory infections. Cochrane Database Syst Rev 2017;9:CD004417.
7. Venekamp RP, Sanders SL, Glasziou PP et al. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2015;2015:CD000219.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.