ACP and CDC Issue Advice for Prescribing Antibiotics

For the common cold, doctors are recommended not to prescribe antibiotics and focus on treating symptoms, with additional treatments considered if symptoms continue for more than two weeks or get worse, although antibiotics still would not help.

In a paper published today in Annals of Internal Medicine, the American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) issued advice for prescribing antibiotics for acute respiratory tract infections (ARTIs) in adults.

The recommendations have not changed dramatically since 2001, but they reinforce more recent guidelines from other groups. Doctors have been warned for years but they still overprescribe antibiotics for acute respiratory infections though majority are caused by viruses on which the drugs don’t work.

To remind physicians about good antibiotic stewardship, ACP and CDC focused on four conditions that most likely will resolve on their own: the common cold, uncomplicated bronchitis, sore throats, and uncomplicated sinus infection.

The good news? Overall antibiotic prescription is down from the 1990s, most dramatically in children.

Doctors should inform their patients about the benefits and risks of undergoing symptomatic therapy, which is often recommended for managing symptoms of the common cold.

For patients with uncomplicated bronchitis, physicians should not perform testing or prescribe antibiotics unless pneumonia is suspected. “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”. Patients can have cough suppressants, expectorants, antihistamines, decongestants, and beta agonists instead. This makes antibiotic use unnecessary as it would not improve symptoms and could even produce adverse effects. A rapid strep test is available if patients have suspicious symptoms such as persistent fever, night sweats or swollen tonsils. However, it’s better to try over-the-counter medication and monitor the patient’s situation than over-prescribe antibiotics. It’s true that you could have a sinus infection, but antibiotics only work on bacterial infections, not viral ones, and your snot color is not actually a crystal ball that can illuminate the underlying cause of your illness. Analgesics may be offered for pain and antipyretics for fever.

Dr. Vincent Meoli, the Regional Medical Director of Doctor’s Express, told 22News some patients will even get sicker after taking antibiotics.