Chapter 6: Respiratory Tract Infection

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6.1. Respiratory tract infection

6.1.1 Indications for antibiotic therapy in URTI

6.1.1.1.   Persistent symptoms of acute rhinosinusitis lasting for ≥ 10 days without clinical improvement;

6.1.1.2.   Severe symptoms or signs including high fever, purulent nasal drainage or facial pain lasting for at least 3 –4 consecutive days at the beginning of the illness;

6.1.1.3.   Onset with worsening symptoms or signs characterized by the new onset of fever, headache, or increase in nasal discharge following a typical viral upper respiratory infection (URI) that lasted 5–6 days and were initially improving (“double-sickening”).

6.1.2 Patient Risk Stratification

6.1.2.1. Patient Type 1 (CAI):

6.1.2.1.1. Patient No contact with health care system
6.1.2.1.2. No prior antibiotic treatment in last 90 days
6.1.2.1.3. Patient young with no co-morbid conditions

6.1.2.2. Type 2 (HCAI):

6.1.2.2.1. Recent contact with health care system (e.g. recent hospital admission, nursing home, CAPD) without/minimal invasive procedures
6.1.2.2.2. Antibiotic therapy in last 90 days
6.1.2.2.3. Patient old (> 65 years) with few co-morbidities