Antibiotic stewardship

The SPILF recommends the use of antibiotherapy for upper respiratory tract infections as follows.Antibiotics MUST NOT BE PRESCRIBED (because of their individual and collective impact) in the following cases: Rhinopharyngitis, even in case of nasal purulent or mucopurulent discharge Pharyngitis with negative RDT or if RDT was not used Congestive otitis in children Seromucosal otitis in children Cases in which IT IS RECOMMENDED to prescribe an antibiotic: Acute purulent otitis media: in children under 2 years of age, in children 2 years of age or more: after re-evaluation at 48-72 hours if initial symptoms were mild, or initial antibiotic therapy in case of pyrexia, intense otalgia, or difficulty to understand tasks, in adults Acute adult sinusitis, in the following cases: frontal, ethmoid, or sphenoid sinusitis acute maxillary sinusitis, or failure of initial symptomatic treatment, or complications unilateral maxillary sinusitis associated to superior homolateral dental infection Acute sinusitis in children, presenting as: severe acute maxillary or frontal sinusitis symptoms of rhinopharyngitis present for more than 10 days without any sign of improvement, or worsening secondarily Group A streptococcal pharyngitis: with a positive RDT in children 3 years of age or more. Amoxicillin is recommended as first line antibiotic for upper respiratory tract infections The benefit/risk of other antibiotics is less favorable. They may be prescribed in specific cases.