Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults
Authors: Aaron M. Harris, Lauri A. Hicks, Amir Qaseem
Journal: Annals of Internal Medicine (2016)

Letters1 November 2016Appropriate Antibiotic Use for Acute Respiratory Tract Infection in AdultsAaron M. Harris, MD, MPH, Lauri A. Hicks, DO, and Amir Qaseem, MD, PhD, MHAAaron M. Harris, MD, MPHFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and American College of Physicians, Philadelphia, Pennsylvania., Lauri A. Hicks, DOFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and American College of Physicians, Philadelphia, Pennsylvania., and Amir Qaseem, MD, PhD, MHAFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and American College of Physicians, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0284 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Matthys's comments and acknowledge that—even when patients with pharyngitis meet recommended criteria for group A streptococcal testing—as many as 20% of children and fewer adults will have a positive result from colonization rather than true disease (1). This factor leads to overuse of antibiotics for pharyngitis.In a recent study examining outpatient antibiotic prescribing, pharyngitis was 1 of the conditions for which antibiotics were most commonly prescribed; 56% and 72% of pediatric and adult pharyngitis cases, respectively, resulted in an antibiotic prescription far exceeding estimates of the true prevalence of group A streptococcal infection and ...References1. Bennnett JE, eds. Dolin R, eds. Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia: Saunders; 2014. Google Scholar2. Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315:1864-73. [PMID: 27139059] doi:10.1001/jama.2016.4151 CrossrefMedlineGoogle Scholar3. Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55:1279-82. [PMID: 23091044] doi:10.1093/cid/cis847 CrossrefMedlineGoogle Scholar4. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013:CD000023. [PMID: 24190439] doi:10.1002/14651858.CD000023.pub4 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Centers for Disease Control and Prevention, Atlanta, Georgia, and American College of Physicians, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1840. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAppropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention Aaron M. Harris , Lauri A. Hicks , Amir Qaseem , and Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults Jan Matthys Metrics Cited byDiseases of the Respiratory TractReduction in ambulatory visits for acute, uncomplicated bronchitis: an unintended but welcome result of the coronavirus disease 2019 (COVID-19) pandemicImplementation of the WHO Approved "Tailoring Antimicrobial Resistance Programs (TAP)" Reduces Patients' Request for AntibioticsImpact of an electronic best-practice advisory in combination with prescriber education on antibiotic prescribing for ambulatory adults with acute, uncomplicated bronchitis within a large integrated health systemPattern of antibiotic prescriptions for outpatients with acute respiratory tract infections in Japan, 2013–15: a retrospective observational studyRespiratory viral infectionsNational Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults—United States, 2011–2015Clonorchis sinensis cyclophilin A immunization protected mice from CLP-induced sepsis9. Practical Strategies for Infectious Diseases Treatment to Combat Antibiotic ResistanceOutpatient Antibiotic Stewardship: A Growing Frontier—Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic UseAntibiotic Prescribing for Uncomplicated Acute Bronchitis Is Highest in Younger AdultsOutpatient antibiotic stewardship: Interventions and opportunities 1 November 2016Volume 165, Issue 9Page: 674KeywordsAntibiotic resistanceAntibioticsChildrenDisclosureInfectious diseasesPharyngitisStreptococcal infectionsStreptococcal pharyngitisStreptococcusUpper respiratory tract infections ePublished: 1 November 2016 Issue Published: 1 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...