Pharmacological treatment of bacterial infections of the respiratory tract

Bacterial infection of the respiratory tract is amongst the commonest presentations to primary and secondary care. In addition to supportive care the mainstay of pharmacotherapy is antibiotics. Antibiotic treatment of bacterial infections of the respiratory tract needs to consider patient factors such as age, co-morbidities, location, previous antibiotic use, microbiological results and allergy. The emergence of multi-drug-resistant bacteria, partly a consequence of inappropriate antibiotic use, has both focussed the need for careful management of bacterial infection and presented a new therapeutic challenge. The choice of antibiotic for respiratory infections needs to be within national guidelines modified by local susceptibility profiles. Bacterial infections of the respiratory tract affect all levels of the airway tree and can be simply classified by their anatomical location for example: epiglottitis, exacerbations of chronic obstructive pulmonary disease and bronchiectasis and pneumonia. As with all pharmacotherapy alongside the benefit the potential side effects of the treatment needs to be considered. This is particularly important for the 6-month treatment of tuberculosis, which should only be managed by a specialist. The majority of bacterial infections of the respiratory tract respond well to therapy, but it is important to recognize that this remains a major cause of mortality.