How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel

Revista Brasileira de Otorrinolaringologia

Santos, Marco Cesar Jorge¹  Bezerra, Thiago Freire Pinto²  Testa, José Ricardo Gurgel³  Romano, Fabrizio Ricci⁴  Sá, Leonardo Conrado Barbosa⁵  Sakano, Eulalia⁶  Padua, Francini Greco⁷  Lubianca Neto, José Faibes⁸  Di Francesco, Renata Cantisani⁹  Kosugi, Eduardo Macoto^1,10  Piltcher, Otávio Bejzman^1,11  Mitre, Edson Ibrahim^1,12  Roithmann, Renato^1,13  Mion, Olavo^1,14  Valera, Fabiana Cardoso Pereira^1,15 

[1] Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil;Hospital Albert Einstein, São Paulo, Brazil;Hospital Infantil Sabará, São Paulo, Brazil;Hospital Paranaense de Otorrinolaringologia, Curitiba, Brazil;Pontifícia Universidade Católica de Goiás, Goiânia, Brazil;Universidade Estadual de Campinas, Campinas, Brazil;Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil;Universidade Federal de Goiás, Goiânia, Brazil;Universidade Federal de Pernambuco, Recife, Brazil;Universidade Federal de São Paulo, São Paulo, Brazil;Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;Universidade Luterana do Brasil, Porto Alegre, Brazil;Universidade de São Paulo, Ribeirão Preto, Brazil;Universidade de São Paulo, São Paulo, Brazil;Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

关键词: Upper respiratory tract infections;    Antibiotic;    Microbial drug resistance;    Acute rhinosinusitis;    Acute otitis media.;   

DOI  :  10.1016/j.bjorl.2018.02.001

学科分类：医学（综合）

来源: Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial

【 摘 要 】

Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections.Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality.Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists.Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into ‘consideration'.Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

【 授权许可】

CC BY