Outpatient antibiotic therapy as a predisposing factor for bacterial resistance: a rational approach to airway infections.
OBJECTIVE
To present evidence-based recommendations for the use of antibiotics for the treatment of the most common acute respiratory infections (ARI) and the available information on the importance of this type of management.


METHODS
MEDLINE and LILACS databases, technical publications by international organizations, national and international directives. The search terms acute respiratory infection, otitis, sinusitis, tonsillitis, pneumonia, antibiotic, guidelines and bacterial resistance were used. Articles cited by the articles selected were analyzed for information of interest.


RESULTS
Bacterial resistance has grown, to the extent that today it is recognized as a global public health problem. ARI are the most common cause of antibiotic usage within the community; yet a large proportion of these cases, compromising the upper (otitis, sinusitis, tonsillitis) or the lower airways (pneumonia), are the result of viral infections. Recommendations to rationalize the use of antibiotics in patients with ARI have the common objective of minimizing unnecessary antibiotic use, since "antibiotic pressure" is one of the factors triggering bacterial resistance.


CONCLUSIONS
It is of great importance to differentiate among ARI patients those who will benefit from the use of antibiotics. The establishment of recommendations for the prescription of antibiotics is one strategy for minimizing the frequency of bacterial resistance.
Nascimento-Carvalho
Cristiana M
CM
Departamento de Pediatria, Faculdade de Medicina, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil. nascimentocarvalho@hotmail.com
D000208:Acute Disease; D000293:Adolescent; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006193:Haemophilus influenzae / Q000187:drug effects; D006801:Humans; D001936:Moraxella catarrhalis / Q000187:drug effects; D010033:Otitis Media / Q000188:drug therapy / Q000382:microbiology; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D017410:Practice Guidelines as Topic; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects; D013297:Streptococcus pyogenes / Q000187:drug effects; D014069:Tonsillitis / Q000188:drug therapy / Q000382:microbiology; D019564:Unnecessary Procedures