No antibiotics for common respiratory infections: IMA
New Delhi, January 20, 2015: The Indian Medical Association recommends that doctors should not prescribe antibiotics for adults who have the common cold, bronchitis, sore throat or sinus infections. These types of infections are the most common reason for visits to the doctor and for outpatient antibiotic prescriptions for adults.
“50 percent of antibiotic prescriptions may be unnecessary or inappropriate in the outpatient setting”, said Dr SS Agarwal National President and Dr K K Aggarwal Honorary Secretary General IMA. Inappropriate use of antibiotics for ARTIs is an important factor contributing to the spread of antibiotic-resistant infections, which is a public health threat, they added
The guidelines released by IMA are at par with that of the American College of Physicians and the U.S. Centers for Disease Control and Prevention. According to them:
- IMA members must communicate to their patients suffering from a common cold that symptoms can last up to two weeks
- One should intervene only if the symptoms worsen or exceed the expected time of recovery.
- Antibiotics should also not be prescribed for uncomplicated bronchitis unless pneumonia is suspected. In such situations symptomatic relief using cough suppressants, expectorants, antihistamines, decongestants and beta-agonists are sufficient.
- Antibiotics should be prescribed for a sore throat only if a strep test confirms streptococcal pharyngitis. For all other cases, one should recommend analgesic therapy such as aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs, and throat lozenges, which can help reduce pain.
Uncomplicated sinus infections typically clear up without antibiotics. Antibiotics should be prescribed only if there are persistent symptoms for more than 10 days, or if a patient develops severe symptoms or a high fever, has nasal discharge or facial pain for at least three days in a row, or "worsening symptoms following a typical viral illness that lasted five days, which was initially improving.