The paper includes four pieces of “high-value care advice:”
- Clinicians should not perform testing or initiate antibiotic therapy in patients with bronchitis unless pneumonia is suspected.
- Clinicians should test patients with symptoms suggestive of group A streptococcal pharyngitis (for example, persistent fevers, anterior cervical adenitis and tonsillopharyngeal exudates or other appropriate combination of symptoms) by rapid antigen detection test and/or culture for group A streptococcus. Clinicians should treat patients with antibiotics only if they have confirmed streptococcal pharyngitis.
- Clinicians should reserve antibiotic treatment for acute rhinosinusitis for patients with persistent symptoms for more than 10 days, onset of severe symptoms or signs of high fever (>102.2 °F) and purulent nasal discharge or facial pain lasting for at least three consecutive days, or onset of worsening symptoms following a typical viral illness that lasted five days that was initially improving (double sickening).
- Clinicians should not prescribe antibiotics for patients with the common cold.
“Inappropriate use of antibiotics for acute respiratory tract infections is an important factor contributing to the spread of antibiotic-resistant infections, which is a public health threat,” ACP president Wayne Riley, MD, said in a news release accompanying the guidelines. “Reducing overuse of antibiotics for ARTIs in adults is a clinical priority and a High Value Care way to improve quality of care, lower health care costs, and slow and/or prevent the continued rise in antibiotic resistance.”
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