Use of Antibiotics
Approximately 5 million people die of acute respiratory tract infections annually, and of these deaths, pneumonia is the most common cause.
The National Prescribing Service (NPS) recommends considered use of antibiotics in treating respiratory tract infections, including upper and lower tract infections, bronchitis and sinusitis.
Over recent years, consumers have been educated via the “Common Colds need Common Sense” campaign, which as well as offering tips on prevention and hygiene, plus an explanation of the difference between colds and influenza, explains that influenza, colds and most coughs are viral in origin, and will not respond to treatment with antibiotics.
Antibiotics have a role to play where a clear benefit exists, according to the NPS. One such area of benefit may include Aboriginal and Torres Strait Islander patients, who more frequently develop complications such as pneumonia and ear damage from respiratory tract infections.
Patients whose respiratory symptoms appear bacterial in origin are also likely to benefit from antibiotic therapy.
Doctors are encouraged to specify the duration of treatment when prescribing antibiotics. Treatment duration should be minimised in order to reduce selection for antibiotic resistance.
A recent Cochrane review showed that treatment of acute bronchitis with suspected bacterial cause with azithromycin, macrolide antibiotic, results in a lower incidence of adverse events and treatment failure than amoxicillin or amoxyclav.
In acute lower respiratory tract infection there was unclear evidence that azithromycin was more efficacious than the other two antibiotics examined, and the review authors said more high-quality trials were needed.
National Prescribing Service: www.nps.org.au