Don’t routinely prescribe antibiotics for acute upper airway infections. Assess the opportunity in patients at risk of lower respiratory tract infection or in case of clinical worsening after a few days

Upper respiratory tract infections (including acute otitis media) are usually caused by viruses and recover spontaneously in a few days. The routine use of antibiotics raises the risk of bacterial resistance and side effects. Patients at risk of lower respiratory infection or complications and patients with worsening symptoms should be reassessed because they could benefit from antibiotic treatment. Persistent rhinitis and cough are not per se signs of bacterial infection.


1. NICE Clinical Guidelines 69. Respiratory Tract Infections-antibiotic prescribing: prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care. July 2008.
2. Linee guida NSGL - La gestione della sindrome influenzale – Doc. 16, 2008.
3. Rossi A. Quali pazienti trattare con terapia antibiotica nelle infezioni delle vie respiratorie. Rivista SIMG, 5, 2009.
4. CeVEAS. Pacchetto informativo farmaci Regione Emilia-Romagna faringo-tonsilliti. 4, 2006. 5. Hersh AL et al and the Committee on Infectious Diseases. Principles of Judicious Antibiotic Prescribing for Bacterial Upper Respiratory Tract Infections in Pediatrics. Pediatrics 2013; 132: 1146–1154.

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.