Do not prescribe antibiotics for viral acute respiratory tract diseases (ear infections, sinusitis, pharyngitis, bronchitis)

Type of practice


Topic Area


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.


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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.
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