Antibiotic prescribing for self limiting respiratory tract infections in primary care: summary of NICE guidance

• Published in: BMJ Vol. 337; no. jul23 3; p. a437
• Main Authors: Tan, Toni, Little, Paul, Stokes, Tim
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 23-07-2008; BMJ Publishing Group LTD; BMJ Publishing Group
• Edition: International edition
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Antibiotics; Cerebrospinal Fluid Otorrhea - drug therapy; Child; Child, Preschool; Colds; Cough - drug therapy; Counseling; Ear diseases; Family Practice; Fever; Hospitals; Humans; Illnesses; Infant; Infections; Otitis Media - drug therapy; Patient Education as Topic; Pharmaceutical industry; Pharyngitis - drug therapy; Practice Patterns, Physicians; Prescriptions; Primary care; Quality of life; Respiratory diseases; Respiratory Tract Infections - drug therapy; Risk Factors; Tonsillitis; Tonsillitis - drug therapy
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.a437

Management strategies for antibiotics Adults and children (3 months or older) with acute otitis media; acute sore throat, acute pharyngitis, or acute tonsillitis; common cold; acute rhinosinusitis; acute cough or acute bronchitis At the first face to face contact in primary care, offer a clinical assessment that includes a history (presenting symptoms, use of over the counter or self medication, medical history, relevant risk factors, relevant comorbidities) and, if indicated, an examination to identify relevant clinical signs. 3 [Based on good quality, individual patient data meta-analysis and randomised controlled trials] For all three antibiotic management strategies Advise patients on the usual course of the illness and the average total illness duration (acute otitis media: four days; acute sore throat, acute pharyngitis, or acute tonsillitis: one week; common cold: one and a half weeks; acute rhinosinusitis: two and a half weeks; acute cough or acute bronchitis: three weeks) Advise patients how to manage symptoms, including fever (particularly analgesics and antipyretics).