title: Community-acquired upper respiratory tract infections and the role of third-generation oral cephalosporins.
abstract: Common community-acquired infections include those of the upper respiratory tract. In the 1990s, the antimicrobial treatment of upper respiratory tract infections focused on penicillin-resistant Streptococcus pneumoniae. However, following the introduction of a pneumococcal conjugate vaccine, a decrease in invasive pneumococcal disease occurred, and in the case of otitis media a shift towards Haemophilus influenzae as the predominant causative pathogen was observed. Future antimicrobial therapy for outpatient upper respiratory tract infections may need to focus on pathogens such as penicillin-susceptible S. pneumoniae, beta-lactamase-producing H. influenzae, beta-lactamase-negative amoxicillin-resistant H. influenzae and Moraxella catarrhalis. In these circumstances, third-generation oral cephalosporins, such as cefixime and cefdinir, could be increasingly used as an optional first-line therapy in community practice for upper respiratory tract infections suspected to be caused by these key pathogens, as an alternative to amoxicillin-clavulanate.
authors.affiliation: Medical Director Kentucky Pediatric and Adult Research, 201 S. 5th St Bardstown, KY 40004, USA. jhedrick@bardstowncable.net
authors.forename: James A
authors.initials: JA
authors.lastname: Hedrick
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D006801:Humans; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000276:immunology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D022242:Pneumococcal Vaccines