1. What is URTI (upper respiratory tract infection)?

   • Infection of the nose, sinuses or throat which can result in cough, sore throat, nasal congestion, sinusitis 

   • Spread by coughs, sneezes, direct contact

   • Common cold is the most common type of URTI. Other examples include the flu and sinus infections

   • Almost all URTIs are caused by viruses, which antibiotics are not effective against. 

2.  URTI management

   • Most URTIs can be treated with home care

   • Drink plenty of fluids, including clear fluids until you feel better 

   • Take over-the-counter pain medicine such as acetaminophen (Tylenol), Ibuprofen (Advil, Motrin), or naproxen (Aleve) - read all instructions on the labels

3. URTI - When to be concerned

   • If you are getting much sicker, having new trouble breathing, have a new or higher fever or have a new rash, call your doctor or 811

   • If you have a new sore throat, earache, or sinus pain, or cough more deeply or more often, changes in your mucus, call your doctor or 811

   • If you have severe trouble breathing, call 911

4.  Why can’t we use antibiotics?

   • Antibiotics target bacteria, not viruses

   • Antibiotics can reduce inflammation from a viral infection but come with other side effects like diarrhea, vomiting and antibiotic resistance (superbugs)

Wondering about antibiotics?

You Should Know....

Unnecessary use of an antibiotics exposes you to the risks of an allergic reaction and antibiotic side effects, such as nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may kill beneficial bacteria and encourage the development of dangerous antibiotic-resistant bacteria.

Many viral illnesses are a nuisance, but most immune systems are capable of fighting them off and preventing any long term consequences.

ILI (Influenza like illness)

Don’t prescribe antibiotics unless there is clear evidence of secondary bacterial infection (see the recommendations for otitis media, pharyngitis, sinusitis, pneumonia). 

Sore Throat (Uncomplicated pharyngitis)

Don’t routinely prescribe antibiotics unless the patient’s modified Centor score is > 2 AND throat swab culture (or rapid antigen test if available) confirms presence of Group A Streptococcus.  

Don’t perform throat swabs at all for patients with Centor score ≤ 1, OR if there are symptoms of a viral infection such as rhinorrhea, oral ulcers or hoarseness.

Sinus Infections (Uncomplicated sinusitis)

Don’t prescribe antibiotics unless symptoms have persisted for greater than 7-10 days without improvement. 

Differentiating viral rhinosinusitis (VRS) from acute bacterial rhinosinusitis (ABRS) can be challenging. Patients not meeting the below criteria are best managed with a viral prescription.  Antibiotics should only be considered if the patient has at least 2 of the below PODS symptoms, one of those being O or D, AND the patient meets one of the following criteria:

1. The symptoms are severe

2. The symptoms are mild to moderate symptoms if there is no response after a 72 hours trial with nasal corticosteroids.

P: Facial Pain/pressure/fullness; O: Nasal Obstruction; D: Purulent/discolored nasal or postnasal Discharge; S: Hyposmia/anosmia (Smell)

Chest Infection (Pneumonia)

Don’t prescribe antibiotics for pneumonia unless there is objective evidence. 

If access to a chest x-ray is available near your clinic, don’t routinely prescribe antibiotics for suspected pneumonia without confirming the presence of a new consolidation.

Physical examination alone, demonstrating respiratory crackles, is not sufficient to establish a diagnosis of pneumonia and initiate antibiotics in the majority of situations. Patients with no vital sign abnormalities and a normal respiratory examination are unlikely to have pneumonia and most likely don’t need a chest x-ray.