Choosing Wisely:

Antibiotics should not be used for apparent viral respiratory illnesses (sinusitis, pharyngitis, bronchitis).

Rationale and Comments: Although overall antibiotic subscription rates for children have fallen, they still remain alarmingly high. Unnecessary medication use for viral respiratory illnesses can lead to antibiotic resistance and contributes to higher health care costs and the risks of adverse events.
Sponsoring Organizations:
  • American Academy of Pediatrics
  • Sources:
  • American Academy of Pediatrics guidelines
  • Infectious Diseases Society of America guidelines
  • Disciplines:
  • Infectious disease
  • References: • American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774-93.
    • Kelly LF. Pediatric cough and cold preparations. 2004;25(4): 115-23.
    • O’Brien KL, et al. Cough illness/bronchitis–principles of judicious use of antimicrobial agents. Pediatrics. 1998;101 (suppl):178-81.
    • Shulman ST, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-102.
    • Williamson IG, et al. Antibiotics and topical nasal steroids for treatment of acute maxillary sinusitis: a randomized controlled trial. JAMA. 2007;298(21):2487-96.

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