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Upper respiratory tract infection

Condition Overview:

Upper respiratory tract infection (URI) is a nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx, larynx, trachea, and bronchi. The prototype is the illness known as the common cold, which will be discussed here in addition to pharyngitis, sinusitis, and tracheobronchitis. Influenza is a systemic illness that involves the upper respiratory tract and should be differentiated from other causes of URI. Acute laryngotracheobronchitis (croup), epiglottitis, and otitis media are infections that occur primarily in the pediatric population and will not be discussed in this chapter.

Symptoms of URTIs include cough, rhinorrhea (running nose), sore throat, fever, pain and myalgia. Infective agents for URTIs include respiratory viruses, bacteria and fungi. The most common form of URTI by far is a viral infection, otherwise known as the common cold. Common diagnoses include the common cold, rhinitis, sinusitis, pharyngitis, Strep throat, tonsillitis, and laryngitis. Otitis media is an infection of the ear (which is part of the auditory system) often associated with upper respiratory infections. Influenza is a more systemic illness which can also involve the upper respiratory tract and should be recognized as distinct from other causes of URI.

Although viruses are the most likely cause of URIs and do not respond to antibiotic treatment, antibiotics continue to be widely prescribed for this illness. Judicious use of antibiotics can reduce unnecessary adverse effects of antibiotics and development of antimicrobial resistance. In patients with URTIs, antimicrobial therapy generally has been shown to result in symptom resolution 1 to 2 days sooner than when symptomatic measures alone are used. Some high risk patients with underlying pulmonary disease, such as chronic obstructive pulmonary disease (COPD), are more likely to benefit from antibiotics when they develop symptoms consistent with a URTI. Health care providers generally try to educate their patients about the self-limited nature of most URIs and the hazards of inappropriate use of antibiotics for the individual patient and the community.

Avoiding cigarette smoke (quitting smoking yourself, or avoiding second-hand smoke) is one of the most important steps that you can take to reduce respiratory infections. Handwashing is the best way to stop the spread of many infections - if someone in your family has a common cold or influenza, both of you should wash your hands frequently. Immunization against influenza (yearly) and pneumonia (once) is very effective and safe. Even though respiratory tract infections are common, you can prevent many of them by following these simple suggestions.