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Treating Upper Respiratory Infections Properly

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If you seek treatment for an acute respiratory tract infection such as bronchitis, chances are you’ll walk out of your doctor’s office with a prescription for an antibiotic. According to a recent clinical guideline for prescribing antibiotics for acute respiratory tract infections, more than 70 percent of the 100 million annual healthcare visits for acute bronchitis end with an antibiotic prescription—even though more than nine in 10 cases of bronchitis are caused by a virus that can’t be effectively treated with an antibiotic. The guideline from the American College of Physicians (ACP) and the Centers for Disease Control and Prevention maps out specific plans of attack for the four most common acute respiratory complaints: bronchitis, sore throat, sinus infection and the common cold.

Getting relief

The following tips summarize the steps healthy adults should take to treat an uncomplicated respiratory tract infection without antibiotics. Your symptoms may be more severe or you may be more susceptible to complications if you have heart or lung problems, a weakened immune system or a chronic condition such as kidney disease or cancer; are malnourished; or smoke. In such cases, ask your doctor about any additional measures you should take to prevent complications, such as pneumonia.

If you use any prescription or over-the-counter (OTC) drugs, ask your doctor or pharmacist whether they’ll interact with any of the suggested treatments. Carefully read and follow the directions on drug labels and beware of a drug’s side effects. For example, certain antihistamines like Benadryl are not recommended for peo- ple over age 65 because they may cause drowsiness and dizziness.

Acute bronchitis

Uncomplicated bronchitis usually goes away on its own, so treatment is typically focused on symptom relief. Prescription or OTC cough suppressants or expectorants, decongestants and antihistamines may help relieve symptoms. If the flu caused your bronchitis, your doctor may prescribe an antiviral drug. If you have chronic obstructive pulmonary disease (COPD) or asthma, your doctor may prescribe a bronchodilator such as albuterol to ease breathing difficulties. Uncomplicated bronchitis doesn’t benefit from antibiotic treatment.

What you can do: Use a humidifier or a cool mist vaporizer or take warm, steamy showers to relieve nasal symptoms. Rest and drink lots of fluids. Aspirin, a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen can help ease aches and a sore throat. Try soothing a cough with lozenges or honey. Avoid smoking and exposure to secondhand smoke.

When to call your doctor: A rapid heart rate, fever, trouble breathing or shortness of breath and abnormal chest sounds such as rattling could be signs of pneumonia, in which case antibiotics are appropriate. If you are older than 75 and have a persistent cough, contact your doctor; the infection may be more serious.

Sore throat (pharyngitis)

An uncomplicated sore throat generally lasts no longer than a week. Less than 15 percent of sore throats are caused by streptococci bacteria (strep throat) or rare infections such as mononucleosis or hand-foot-and- mouth disease. If coldlike symptoms accompany your sore throat, a virus is the likely culprit and an antibiotic won’t help. Sore throats usually go away on their own with self-care.

What you can do: Nonprescription therapies, such as aspirin, acetaminophen, NSAIDs, nonmedicated lozenges and throat sprays with topical anesthetics, can help relieve the pain of an uncomplicated sore throat. Saltwater gargles, warm beverages like tea or chicken soup, cold drinks, frozen desserts like popsicles and ice cream (low-fat, of course) and ice chips can ease symptoms. Drinking plenty of fluids and using a personal humidifier can help make sure that phlegm stays as thin as possible, to reduce your discomfort. Get plenty of rest, too.

When to call your doctor: If you have a severe sore throat with a persistent fever, night sweats, shivering, swollen tonsils, thick yellow/white mucus sticking to your tonsils or palate, a rash and/or tender lymph nodes, you may have strep throat. Your doctor may prescribe an antibiotic to treat the infection and prevent complica- tions, such as rheumatic fever. See your doctor if your sore throat lasts longer than a week. If you have difficulty swallowing, breathing or opening your mouth; swelling of the tongue or neck; a stiff neck; or a rash, call your doctor immediately.

Sinus infection (rhinosinusitis)

The illness can last as long as a month, though most cases resolve within a week. Your doctor may prescribe a steroid nasal spray or recommend an OTC steroid spray (Nasacort) to relieve nasal inflammation. A prescription mucolypic drug or an OTC version like Mucinex or Robitussin can help clear mucus from the airway. Antibiotics have no effect on acute viral rhinosinusitis.

What you can do: OTC decongestants, antihistamines and pain relievers can reduce symptoms. But follow the directions carefully: OTC decongestant nasal spray shouldn’t be used for more than three days in a row. Some people find nasal irrigation helpful. This process involves flushing the nose and sinuses with a saline solution. Placing a warm compress over the nose and forehead may help relieve pressure. Rest and drink plenty of fluids.

When to call your doctor: If your symptoms don’t improve after 10 days of treatment, are severe (such as a fever greater than 102.2° F) and persist for at least three days, or improve but then worsen again, your infection may be bacterial, and your doctor may prescribe antibiotics. Even in cases eligible for antibiotics, an uncomplicated acute sinus infection may improve without treatment. See your doctor, too, if you get more than four sinus infections a year. This frequency could indicate chronic sinusitis.

The common cold

You can manage symptoms with self-care, mostly with OTC medicines. As many as 200 different viruses can cause colds, so no one drug exists to cure a cold. Your doctor may prescribe the nasal spray ipratropium bromide to relieve a runny nose. Colds can lead to complications like acute bacterial sinusitis, but taking antibiotics will neither prevent sinus infections nor improve cold symptoms.

What you can do: Nonprescription cromolyn sodium nasal sprays (NasalCrom), decongestants, antihistamines, cough suppressants and pain medications can help relieve cold symptoms. To minimize drug-related side effects and get maximum relief, consider a combination product that contains an antihistamine, analgesic and decongestant. Zinc supplements may reduce a cold’s duration if taken within 24 hours of symptom onset, but they can also trigger nausea and alter taste. Research does not support the use of herbal remedies like echinacea or vitamin C for cold prevention or treatment. A humidifier, cool mist vaporizer and warm, steamy showers can improve nasal congestion and runny nose. Rest and drink plenty of fluids.

When to call your doctor: If your temperature rises above 102° F, your symptoms last longer than 10 days or symptoms are severe or unusual, call your doctor to rule out something more serious such as pneumonia. If your cold symptoms are accompanied by severe muscle aches, intense fatigue or severe headache, you may have influenza; contact your doctor as some prescription antiviral medicine may reduce the severity and length of your symptoms.

When it doesn’t get better

If your doctor doesn’t think your condition warrants an antibiotic, yet your illness isn’t improving within the expected time frame, or it worsens, it may be time to see your doctor for reevaluation. 

 

Posted in Lung Disorders on April 29, 2016


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer


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