Rational use of antibiotics in adults in general practice – from the right diagnosis to the right treatment duration

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Sophie Paternostre (1), Leila Belkhir (1), Jean-Cyr Yombi (1) Published in the journal : October 2018 Category : Actualité thérapeutique

Summary :

Respiratory, urinary, and cutaneous infections make up a significant proportion of general practice consultations. Few new antibiotics are available on the market and given the increase of multiresistant bacteria, a rational use of antibiotics proves necessary. Rhinopharyngitis, rhinosinusitis, and bronchitis are most often of viral origin, and treatment is therefore symptomatic. Antibiotics are only required in case of suspected bacterial superinfection, in which case treatment duration is 5 days. Among urinary tract infections, a distinction should be made between complicated and uncomplicated infections, while taking into account some specific risk factors. Both can be complicated by severe sepsis. Escherichia coli remains the predominant uropathogen. There is an increase in multiresistant bacteria, even in the community. Asymptomatic bacteriuria (AB) is common, especially among elderly people. Screening and treatment of AB are indicated only in pregnant women and patients undergoing urinary tract instrumentation with a risk of mucosal bleeding. Skin infections, such as impetigo, do not always require systemic antibiotics. This article is aimed at supplementing and updating the data of an article on the rational use of antibiotics in general medicine published in 2015 in the same journal. It additionally includes recent data on the management of pneumonia, pertussis, and skin infections.

What is already known about the topic?

Respiratory, urinary, and cutaneous infections make up a significant part of general medical consultations and account for a large part of antibiotic prescriptions.

What does this article bring up for us?

This article clarifies the indications and duration of antibiotic treatment in respiratory, urinary, and cutaneous infections.

Key words

Antibiotics, respiratory tract infection, urinary tract infection, skin infection