This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dowell, S. F.
Right arrow Articles by Schwartz, B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Dowell, S. F.
Right arrow Articles by Schwartz, B.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 101 No. 1 Supplement January 1998, pp. 163-165

Principles of Judicious Use of Antimicrobial Agents for Pediatric Upper Respiratory Tract Infections

Received Aug 8, 1997; accepted Sep 11, 1997.

Scott F. Dowell*, S. Michael MarcyDagger , William R. Phillips§, Michael A. Gerberparallel , and Benjamin Schwartz*

From the * Childhood and Respiratory Diseases Branch, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Dagger  Kaiser Permanente, Panorama City, California; § Northwest Family Medicine, Seattle, Washington; and parallel  Connecticut Children's Medical Center, Hartford, Connecticut.

This article introduces a set of principles to define judicious antimicrobial use for five conditions that account for the majority of outpatient antimicrobial use in the United States. Data from the National Center for Health Statistics indicate that in recent years, approximately three fourths of all outpatient antibiotics have been prescribed for otitis media, sinusitis, bronchitis, pharyngitis, or nonspecific upper respiratory tract infection. Antimicrobial drug use rates are highest for children; therefore, the pediatric age group represents the focus for the present guidelines. The evidence-based principles presented here are focused on situations in which antimicrobial therapy could be curtailed without compromising patient care. They are not formulated as comprehensive management strategies. For most upper respiratory infections that require antimicrobial treatment, there are several appropriate oral agents from which to choose. Although the general principles of selecting narrow-spectrum agents with the fewest side effects and lowest cost are important, the principles that follow include few specific antibiotic selection recommendations.

Key words: antimicrobial resistance, antimicrobial use, upper respiratory infection, otitis media, pediatrics, sinusitis.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 CLIN PEDIATRHome page
J. R. Casey and M. E. Pichichero
A Comparison of 2 White Blood Cell Count Devices to Aid Judicious Antibiotic Prescribing
Clinical Pediatrics, April 1, 2009; 48(3): 291 - 294.
[Abstract] [PDF]

Home page
 Ann Fam MedHome page
C. J. Stille, S. L. Rifas-Shiman, K. Kleinman, J. B. Kotch, and J. A. Finkelstein
Physician Responses to a Community-Level Trial Promoting Judicious Antibiotic Use
Ann. Fam. Med, May 1, 2008; 6(3): 206 - 212.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. A. Finkelstein, S. S. Huang, K. Kleinman, S. L. Rifas-Shiman, C. J. Stille, J. Daniel, N. Schiff, R. Steingard, S. B. Soumerai, D. Ross-Degnan, et al.
Impact of a 16-Community Trial to Promote Judicious Antibiotic Use in Massachusetts
Pediatrics, January 1, 2008; 121(1): e15 - e23.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
Committee on Infectious Diseases
Infection Prevention and Control in Pediatric Ambulatory Settings
Pediatrics, September 1, 2007; 120(3): 650 - 665.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
S. S. Huang, S. L. Rifas-Shiman, K. Kleinman, J. Kotch, N. Schiff, C. J. Stille, R. Steingard, and J. A. Finkelstein
Parental Knowledge About Antibiotic Use: Results of a Cluster-Randomized, Multicommunity Intervention
Pediatrics, April 1, 2007; 119(4): 698 - 706.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
D. M. Spiro, K.-Y. Tay, D. H. Arnold, J. D. Dziura, M. D. Baker, and E. D. Shapiro
Wait-and-see prescription for the treatment of acute otitis media: a randomized controlled trial.
JAMA, September 13, 2006; 296(10): 1235 - 1241.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. G. Grijalva, K. A. Poehling, J. P. Nuorti, Y. Zhu, S. W. Martin, K. M. Edwards, and M. R. Griffin
National Impact of Universal Childhood Immunization With Pneumococcal Conjugate Vaccine on Outpatient Medical Care Visits in the United States
Pediatrics, September 1, 2006; 118(3): 865 - 873.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. Garbutt, I. Rosenbloom, J. Wu, and G. A. Storch
Empiric first-line antibiotic treatment of acute otitis in the era of the heptavalent pneumococcal conjugate vaccine.
Pediatrics, June 1, 2006; 117(6): e1087 - e1094.
[Abstract] [Full Text] [PDF]

Home page
 J Antimicrob ChemotherHome page
Y. Razon, S. Ashkenazi, A. Cohen, E. Hering, S. Amzel, H. Babilsky, A. Bahir, E. Gazala, and I. Levy
Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children: a multicentre study
J. Antimicrob. Chemother., November 1, 2005; 56(5): 937 - 940.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. J. Stille, S. E. Andrade, S. S. Huang, J. Nordin, M. A. Raebel, A. S. Go, K. A. Chan, and J. A. Finkelstein
Increased Use of Second-Generation Macrolide Antibiotics for Children in Nine Health Plans in the United States
Pediatrics, November 1, 2004; 114(5): 1206 - 1211.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. Garbutt, J. W. St. Geme III, A. May, G. A. Storch, and P. G. Shackelford
Developing Community-Specific Recommendations for First-Line Treatment of Acute Otitis Media: Is High-Dose Amoxicillin Necessary?
Pediatrics, August 1, 2004; 114(2): 342 - 347.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. M. Spiro, W. D. King, D. H. Arnold, C. Johnston, and S. Baldwin
A Randomized Clinical Trial to Assess the Effects of Tympanometry on the Diagnosis and Treatment of Acute Otitis Media
Pediatrics, July 1, 2004; 114(1): 177 - 181.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. H. Howard and J. E. McGowan Jr
Initial and Follow-up Costs by Treatment Outcome for Children With Respiratory Infections
Pediatrics, May 1, 2004; 113(5): 1352 - 1356.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Public HealthHome page
A. G. Mainous III, W. J. Hueston, M. P. Davis, and W. S. Pearson
Trends in Antimicrobial Prescribing for Bronchitis and Upper Respiratory Infections Among Adults and Children
Am J Public Health, November 1, 2003; 93(11): 1910 - 1914.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. P. McCormick, K. A. Saeed, C. Pittman, C. D. Baldwin, N. Friedman, D. C. Teichgraeber, and T. Chonmaitree
Bullous Myringitis: A Case-Control Study
Pediatrics, October 1, 2003; 112(4): 982 - 986.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
B. J. McMahon, T. W. Hennessy, J. M. Bensler, D. L. Bruden, A. J. Parkinson, J. M. Morris, A. L. Reasonover, D. A. Hurlburt, M. G. Bruce, F. Sacco, et al.
The Relationship among Previous Antimicrobial Use, Antimicrobial Resistance, and Treatment Outcomes for Helicobacter pylori Infections
Ann Intern Med, September 16, 2003; 139(6): 463 - 469.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. A. Finkelstein, C. Stille, J. Nordin, R. Davis, M. A. Raebel, D. Roblin, A. S. Go, D. Smith, C. C. Johnson, K. Kleinman, et al.
Reduction in Antibiotic Use Among US Children, 1996-2000
Pediatrics, September 1, 2003; 112(3): 620 - 627.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. M. Shea
Antibiotic Resistance: What Is the Impact of Agricultural Uses of Antibiotics on Children's Health?
Pediatrics, July 1, 2003; 112(1): 253 - 258.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
E. O. Ibia, R. H. Schwartz, B. J. Freij, and M. J. Sheridan
Judicious Antibiotic Use for Purulent Rhinorrhea: Do Pediatric Infectious Disease Specialists Practice What They Preach?
Clinical Pediatrics, June 1, 2003; 42(5): 443 - 446.
[PDF]

Home page
 NEJMHome page
C. G. Whitney, M. M. Farley, J. Hadler, L. H. Harrison, N. M. Bennett, R. Lynfield, A. Reingold, P. R. Cieslak, T. Pilishvili, D. Jackson, et al.
Decline in Invasive Pneumococcal Disease after the Introduction of Protein-Polysaccharide Conjugate Vaccine
N. Engl. J. Med., May 1, 2003; 348(18): 1737 - 1746.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. A. Taylor, T. S. C. Kwan-Gett, and E. M. McMahon Jr
Effectiveness of an Educational Intervention in Modifying Parental Attitudes About Antibiotic Usage in Children
Pediatrics, May 1, 2003; 111(5): e548 - 554.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
J. F. Friedman, G. M. Lee, K. P. Kleinman, and J. A. Finkelstein
Acute Care and Antibiotic Seeking for Upper Respiratory Tract Infections for Children in Day Care: Parental Knowledge and Day Care Center Policies
Arch Pediatr Adolesc Med, April 1, 2003; 157(4): 369 - 374.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
J. R. Casey, S. M. Marsocci, M. L. Murphy, A. B. Francis, and M. E. Pichichero
White Blood Cell Count Can Aid Judicious Antibiotic Prescribing in Acute Upper Respiratory Infections in Children
Clinical Pediatrics, March 1, 2003; 42(2): 113 - 119.
[Abstract] [PDF]

Home page
 PediatricsHome page
H. Bauchner and R. E. Besser
Promoting the Appropriate Use of Oral Antibiotics: There Is Some Very Good News
Pediatrics, March 1, 2003; 111(3): 668 - 670.
[Full Text] [PDF]

Home page
 CMAJHome page
E. Wang
Upper respiratory tract infections in children -- Why do parents seek medical consultation?
Can. Med. Assoc. J., January 7, 2003; 168(1): 43 - 43.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
C. L. Byington, H. Castillo, K. Gerber, J. A. Daly, L. A. Brimley, S. Adams, J. C. Christenson, and A. T. Pavia
The Effect of Rapid Respiratory Viral Diagnostic Testing on Antibiotic Use in a Children's Hospital
Arch Pediatr Adolesc Med, December 1, 2002; 156(12): 1230 - 1234.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
D. R. Nash, J. Harman, E. R. Wald, and K. J. Kelleher
Antibiotic Prescribing by Primary Care Physicians for Children With Upper Respiratory Tract Infections
Arch Pediatr Adolesc Med, November 1, 2002; 156(11): 1114 - 1119.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
J. F. Perz, A. S. Craig, C. S. Coffey, D. M. Jorgensen, E. Mitchel, S. Hall, W. Schaffner, and M. R. Griffin
Changes in Antibiotic Prescribing for Children After a Community-wide Campaign
JAMA, June 19, 2002; 287(23): 3103 - 3109.
[Abstract] [Full Text] [PDF]

Home page
 Br Med BullHome page
J V West
Acute upper airway infections: Childhood respiratory infections
Br. Med. Bull., March 1, 2002; 61(1): 215 - 230.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
H. Bauchner, S. Osganian, K. Smith, and R. Triant
Improving Parent Knowledge About Antibiotics: A Video Intervention
Pediatrics, October 1, 2001; 108(4): 845 - 850.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. G. Wheeler, M. Fair, P. M. Simpson, L. A. Rowlands, M. E. Aitken, and R. F. Jacobs
Impact of a Waiting Room Videotape Message on Parent Attitudes Toward Pediatric Antibiotic Use
Pediatrics, September 1, 2001; 108(3): 591 - 596.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
Subcommittee on Management of Sinusitis and Commit
Clinical Practice Guideline: Management of Sinusitis
Pediatrics, September 1, 2001; 108(3): 798 - 808.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
L. S. Chan, G. S. Takata, P. Shekelle, S. C. Morton, W. Mason, and S. M. Marcy
Evidence Assessment of Management of Acute Otitis Media: II. Research Gaps and Priorities for Future Research
Pediatrics, August 1, 2001; 108(2): 248 - 254.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. M. Garbutt, M. Goldstein, E. Gellman, W. Shannon, and B. Littenberg
A Randomized, Placebo-Controlled Trial of Antimicrobial Treatment for Children With Clinically Diagnosed Acute Sinusitis
Pediatrics, April 1, 2001; 107(4): 619 - 625.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
Committee on Infectious Diseases and Committee on
Infection Control in Physicians' Offices
Pediatrics, June 1, 2000; 105(6): 1361 - 1369.
[Abstract] [Full Text]

Home page
 Arch Pediatr Adolesc MedHome page
J. A. Finkelstein, J. P. Metlay, R. L. Davis, S. L. Rifas-Shiman, S. F. Dowell, and R. Platt
Antimicrobial Use in Defined Populations of Infants and Young Children
Arch Pediatr Adolesc Med, April 1, 2000; 154(4): 395 - 400.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
M. E. Pichichero, J. L. Green, A. B. Francis, S. M. Marsocci, and M. L. Murphy
Outcomes After Judicious Antibiotic Use for Respiratory Tract Infections Seen in a Private Pediatric Practice
Pediatrics, April 1, 2000; 105(4): 753 - 759.
[Abstract] [Full Text]

Home page
 J Antimicrob ChemotherHome page
A. R. Bremon, M. Ruiz-Tovar, B. P. Gorricho, P. D. de Torres, and R. L. Rodriguez
Non-hospital consumption of antibiotics in Spain: 1987-1997
J. Antimicrob. Chemother., March 1, 2000; 45(3): 395 - 400.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. I. Harwell and R. B. Brown
The Drug-Resistant Pneumococcus: Clinical Relevance, Therapy, and Prevention
Chest, February 1, 2000; 117(2): 530 - 541.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. A. Finkelstein, C. L. Christiansen, and R. Platt
Fever in Pediatric Primary Care: Occurrence, Management, and Outcomes
Pediatrics, January 1, 2000; 105(1): 260 - 266.
[Abstract] [Full Text]

Home page
 Antimicrob. Agents Chemother.Home page
M. R. Jacobs, S. Bajaksouzian, A. Zilles, G. Lin, G. A. Pankuch, and P. C. Appelbaum
Susceptibilities of Streptococcus pneumoniae and Haemophilus influenzae to 10 Oral Antimicrobial Agents Based on Pharmacodynamic Parameters: 1997 U.S. Surveillance Study
Antimicrob. Agents Chemother., August 1, 1999; 43(8): 1901 - 1908.
[Abstract] [Full Text]

Home page
 JAMAHome page
R. Sehgal and J. P. Burke
Combating Antimicrobial Resistance in India
JAMA, March 24, 1999; 281(12): 1081 - 1082.
[Full Text] [PDF]

Home page
 JAMAHome page
R. F. Chen, J. M. Westfall, T. Fahey, N. Stocks, S. H. Woolf, N. Brooks, A.-C. Nyquist, R. Gonzales, J. F. Steiner, M. A. Sande, et al.
Antibiotics for Children With Upper Respiratory Tract Infections
JAMA, October 28, 1998; 280(16): 1399 - 1402.
[Full Text] [PDF]

Home page
 BMJHome page
E. A Belongia and B. Schwartz
Strategies for promoting judicious use of antibiotics by doctors and patients
BMJ, September 5, 1998; 317(7159): 668 - 671.
[Full Text]

Home page
 PediatricsHome page
S. L. Kaplan, E. O. Mason Jr, W. J. Barson, E. R. Wald, M. Arditi, T. Q. Tan, G. E. Schutze, J. S. Bradley, L. B. Givner, K. S. Kim, et al.
Three-Year Multicenter Surveillance of Systemic Pneumococcal Infections in Children
Pediatrics, September 1, 1998; 102(3): 538 - 545.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. C. Goodman and G. A. Little
General Pediatrics, Neonatology, and the Law of Diminishing Returns
Pediatrics, August 1, 1998; 102(2): 396 - 398.
[Full Text] [PDF]

Home page
 PediatricsHome page
H. Bauchner and B. Philipp
Reducing Inappropriate Oral Antibiotic Use: A Prescription for Change
Pediatrics, July 1, 1998; 102(1): 142 - 144.
[Full Text]

Home page
 Pediatr. Rev.Home page
B. L. Wiedermann and T. L. Cheng
Macrolides: Clarithromycin and Azithromycin
Pediatr. Rev., July 1, 1998; 19(7): 238 - 239.
[Full Text] [PDF]

Home page
 JAMAHome page
B. Schwartz, A. G. Mainous III, and S. M. Marcy
Why Do Physicians Prescribe Antibiotics for Children With Upper Respiratory Tract Infections?
JAMA, March 18, 1998; 279(11): 881 - 882.
[Full Text] [PDF]