#Sanford guide to antimicrobial tx free#

At least 200 viruses can cause the common cold.

The common cold is the third most frequent diagnosis in office visits, and most adults experience two to four colds annually.

First-generation antihistamines (diphenhydramine) Д®vidence supporting specific symptomatic therapies is limited.Д¬ommon cold or non-specific upper respiratory tract infection (URI) 6, 7.

Cough suppressants (codeine, dextromethorphan).

Routine treatment of uncomplicated acute bronchitis with antibiotics is not recommended, regardless of cough duration.

For most cases, chest radiography is not indicated.

Colored sputum does not indicate bacterial infection.

Evaluation should focus on ruling out pneumonia, which is rare among otherwise healthy adults in the absence of abnormal vital signs (heart rate в‰Ґ 100 beats/min, respiratory rate в‰Ґ 24 breaths/min, or oral temperatureв‰Ґ 38 вЊ) and abnormal lung examination findings (focal consolidation, egophony, fremitus).

Cough is the most common symptom for which adult patients visit their primary care provider, and acute bronchitis is the most common diagnosis in these patients.

For penicillin-allergic patients, doxycycline or a respiratory fluoroquinolone (levofloxacin or moxifloxacin) are recommended as alternative agents.

Macrolides such as azithromycin are not recommended due to high levels of Streptococcus pneumoniae antibiotic resistance (~40%).

Amoxicillin or amoxicillin/clavulanate is the recommended first-line therapy.

Watchful waiting is encouraged for uncomplicated cases for which reliable follow-up is available.

Sinus radiographs are not routinely recommended.

Worsening (3-4 days) such as worsening or new onset fever, daytime cough, or nasal discharge after initial improvement of a viral upper respiratory infections (URI) lasting 5-6 days.

Persistent (>10 days) without improvement, such as nasal discharge or daytime cough or.

Severe (>3-4 days), such as a fever в‰Ґ39вЊ (102вЏ) and purulent nasal discharge or facial pain.

Diagnose acute bacterial rhinosinusitis based on symptoms that are:.

NinetyвЂ“98% of rhinosinusitis cases are viral, and antibiotics are not guaranteed to help even if the causative agent is bacterial.

About 1 out of 8 adults (12%) in 2012 reported receiving a diagnosis of rhinosinusitis in the previous 12 months, resulting in more than 30 million diagnoses.

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#Sanford guide to antimicrobial tx free#

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