title: Tackling upper respiratory tract infections.
abstract: URTIs are the most common reason for general practice consultations. On average adults suffer two to three such infections per year. When assessing a patient with a URTI in general practice it is important to recognise which patients may require antibiotics, further investigations and/or hospital referral. NICE recommends immediate antibiotics or further investigation and/or management in the following patients who are at risk of complications: Systemically very unwell. Features suggestive of serious illness and complications. Pre-existing comorbidities Older than 65 years with acute cough and two or more of the following, or older than 80 years with acute cough and one or more of the following: hospitalisation in the previous year; diabetes; history of congestive heart failure; current use of oral glucocorticoids. Antibiotics should also be considered for patients with three or more Centor criteria. In other cases (acute otitis media, acute sore throat/pharyngitis/acute tonsillitis, common cold, acute rhinosinusitis or acute cough/acute bronchitis) NICE advocates a no prescribing or delayed prescribing strategy. Most URTIs are self-managed. Patients who do seek consultations often benefit from reassurance, education and instructions for symptomatic home treatment.
authors.affiliation: Ninewells Hospital, Dundee.
authors.forename: Arvind
authors.initials: A
authors.lastname: Manoharan
authors.forename: John
authors.initials: J
authors.lastname: Winter
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012648:Self Care; D013577:Syndrome
chemical_list: D000900:Anti-Bacterial Agents