Sunday, April 10, 2011

Upper Respiratory Tract Infections

I have caught a cough bug from the pharmacy. There seemed a big rise in number of people down with cough and URTI recently. Morning I would wake up with stuffy nose and 'phlegmy' throat. It is not that bad in the day, and I don't really cough that much since I am on cough suppressant, except it affects my voice if I talked too much by the end of the day.

I will continue my dose of vitamin C and hopefully it clears. I don't like to take antibiotics although my doctor has given me a course of cefuroxime. Bleah... :P

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A good read on Upper Respiratory Tract Infections
- here's an partial extract on treatment extracted from the Cleveland Clinic article:

Patients with only mild symptoms of acute sinusitis improve with topical nasal steroids and decongestants. Oral amoxicillin, trimethoprim-sulfamethoxazole, or doxycycline, given for 3 to 10 days, are the recommended first-line antibiotics for the treatment of moderate to severe acute sinusitis.2,36 The incidence of penicillin-resistant S. pneumoniae and beta-lactamase–producing organisms causing acute sinusitis has been steadily increasing in the community. However, larger doses of amoxicillin, up to 3 g daily, or a combination of amoxicillin and clavulanate remain effective in most cases caused by resistant organisms.3,10,11,36 Alternative agents include cefpodoxime, cefuroxime, and cefdinir. Factors predisposing patients to have antibiotic-resistant organisms include recent antibiotic use and exposure to children who attend daycare centers. Second-line, broad-spectrum, and more expensive agents, including the newer macrolides clarithromycin and azithromycin, and the “respiratory” fluoroquinolones—levofloxacin, gatifloxacin, and moxifloxacin—are no more effective than amoxicillin.37 These agents should be reserved for use in individuals who are allergic or intolerant to first-line agents, those who do not respond to first-line agents within 3 days, or for confirmed microbiologic resistance. This approach would help contain ever-increasing health care costs and, most importantly, curtail the emergence of drug-resistant organisms as a result of selection pressure.

Treating acute tracheobronchitis with antibiotics is not recommended, because most cases are viral and thus resolve spontaneously.4,38 In adults with persistent cough who report exposure to a patient with confirmed or suspected pertussis, erythromycin or trimethoprim-sulfamethoxazole should be administered for 14 days. This decreases contagion from bacterial shedding, but it is not expected to improve resolution of symptoms, unless started within 10 days of the onset of illness. Selective β-agonist bronchodilators offer symptomatic relief for cough.

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Another read for Guidelines for use of Antibiotics in acute URTI from AAFP.

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