EDITORIAL A New Look at an Old Problem: Inappropriate Antibiotics for Acute Respiratory Infections

Upper respiratory tract infection, bronchitis, pharyngitis, sinusitis—every family physician sees hundreds of patients with these com-mon acute respiratory tract infections each year, so we ought to know how to diagnose and treat them. But the evidence shows that there are large gaps between how these mostly self-limited infections ought to be treated and how we do treat them. The central issue is overuse of antibiotics for these overwhelmingly viral infections. The most recently published doctor-bashing study from the United States (led by a family physi-cian, I might add) shows that antibiotics are prescribed for 65 % of episodes of upper respiratory tract infec-tion, 78 % of acute bronchitis, 65 % of acute pharyngi-tis, and 81 % of acute sinusitis.1 These percentages have barely budged since 2000, despite the massive public health campaign by the Centers for Disease Contro