Upper Respiratory Infection

MDNG Primary CareDecember 2010
Volume 12
Issue 12

Online CMEClinical Decisions Case-based Lesson: Upper Respiratory Tract InfectionsCredits:0.25

Fee: None

Expires: June 15, 2012

Multimedia: None

This brief, question-and-answer-based course focuses on the clinical manifestations of upper respiratory tract infections (URIs), appropriate management of URI, and counseling of patients on how to prevent the spread of upper respiratory tract infections.


Pharyngitis in Children and Adults

Credits: 1.00

Fee: None

Expires: September 2012

Multimedia: None

Although viruses are the most common causes of cases of pharyngitis, group A beta hemolytic Streptococcusinfection (GABHS) “can be the cause in children (15%-30%) and adults (5%-10%).” This activity will provide physicians with the knowledge to determine which cases of pharyngitis are caused by GABHS. The primary reason to identify and treat GABHS—“to decrease the risk of acute rheumatic fever”—is discussed, as well as the growing concern about “the indiscriminate use of antibiotics.”



Developing a Computer Delivered, Theory Based Intervention for Guideline Implementation in General Practice

Journal: BMC Family Practice(November 18, 2010)

Authors: McDermott L, Yardley L, Little P, et al.

Purpose: To “develop computer-delivered prompts to promote guideline adherence for antibiotic prescribing in respiratory tract infections, and adherence to recommendations for secondary stroke prevention.”

Results: General practitioners were more likely to use prompts that were perceived as offering support and choice as opposed to those perceived as methods of enforcement. Anticipated patient outcomes, individual prescriber differences, accessibility and presentation of prompts, and acceptability of guidelines also played a role in physician’s attitudes toward use of the prompts. After prompts were modified based on participant feedback, comments regarding them were mostly positive.


Effect of Two Interventions on Reducing Antibiotic Prescription in Pharyngitis in Primary Care

Journal: Journal of Antimicrobial Chemotherapy(November 16, 2010; online ahead of print)

Authors: Llor C, Maria Cots J, Lopez-Valcarcel B, et al.

Purpose: To “evaluate the effect of two interventions”—discussion sessions of the results of a registry of all pharyngitis cases during a three-week period, courses for general practitioners, guidelines, patient information leaflets, workshops on rapid tests, and use of rapid antigen detection tests (RADTs) in consulting offices versus all of the above minus the workshop and RADTs—“on reducing antibiotic prescription in pharyngitis,”

Results: Although the prescription of antibiotics was reducing with intervention use, reductions were only statistically significant when RADTs were provided to the general practitioners.


Staphylococcus Aureus Sinus Infections in Children

Journal: International Journal of Pediatric Otorhinolaryngology(November 12, 2010; online ahead of print)

Authors: Whitby C, Kaplan S, Mason E, et al.

Purpose: “To describe the clinical characteristics of pediatric patients with S. aureuscultured from sinus specimens, treated at Texas Children's Hospital (TCH), and [characterize] their isolates by molecular methods.”

Results: “MSSA was more commonly isolated than MRSA from sinus cultures of children who underwent ESS at TCH. The majority of ESS cultures positive for S. aureus, were mixed with other respiratory pathogens, principally H. influenzae. USA300 was the major clone among the MRSA sinusitis isolates, but was not associated with more complications than other S. aureusisolates.”


Clinical Trials

Effectiveness of the Acute Respiratory Infection Smart Form

Study Type: Interventional

Age/Gender Requirement: 18 years (male/female)

Sponsor: Agency for Healthcare Research and Quality

Purpose: “To design and implement an integrated documentation-based clinical decision support and physician feedback system, provided in an electronic health record (EHR), to improve the management of patients with acute medical conditions,” with the hypothesis that such systems “can be designed and implemented to facilitate documentation and physician order-entry, provide individualized, evidence-based recommendations for the management of patients acute respiratory infections (ARIs), and are usable by primary care physicians.”


Genetic Factors in Chronic Sinusitis

Study Type: Observational

Age/Gender Requirement: 18 years (male/female)

Sponsor: University of Chicago

Purpose: To “learn more about the genetics of chronic sinusitis and identify genes involved in chronic sinusitis.”


Vitamin D and Health Advice for the Prevention of Upper Respiratory Tract Infections

Study Type: Interventional

Age/Gender Requirement: 17 years (male/female)

Sponsor: St. Joseph's Healthcare

Purpose: To “assess the effectiveness of daily gargling and vitamin D supplementation as preventative measures against incident upper respiratory tract infection,” based on the hypothesis that both vitamin D3 supplementation and gargling will decrease the incidence of symptomatic upper respiratory tract infections.


The Educated PatientTM

Medline Plus Medical Encyclopedia: Pharyngitis

Because most cases of pharyngitis can be treated without the need for prescription medications, the “Treatment” section of this website will be useful for patients who are unsure how to take care of pharyngitis. Remedies are described for reducing pain, such as acetaminophen and use of a cool-mist vaporizer. The information on complications and when additional medical attention may be necessary will also be particularly helpful for patients in determining what symptoms constitute a more serious problem.


Upper Respiratory Infection Causes, Symptoms, and Treatment by MedicineNet.com

This physician-authored and -edited site thoroughly covers all the bases when it comes to upper respiratory infections, from risk factors and diagnosis to home remedies and prevention. Site visits can also view slideshows that cover “the superbug,” infectious mononucleosis, and strep or sore throat. Throughout this resource, key terms are hyperliniked to equally comprehensive information on those topics, including laryngitis, whooping cough, Echinacea, and nonsteroidal anti-inflammatory drugs.


Medical Websites

Acute Pharyngitis in Adults: Physician Information Sheet

The principles described in this CDC guideline “apply to the diagnosis and treatment of Group A ß-hemolytic streptococcal (GABHS) pharyngitis in otherwise healthy adults.” A description of the multi-step process needed to confirm acute pharyngitis will serve as an instant refresher course for physicians, while the treatment section will provide standard options as well as ways for reducing antibiotic use in patients.


From the HCPLive Network

Mom Was Right: Vapor Rub can Help that CoughA study that put an old, commonly used remedy to the test found that vapor rubs can indeed provide symptomatic relief from nocturnal cold symptoms in children.


Primary Care Doctors Need More, Better Info about Sinusitis

Primary care doctors often don't have the latest information on sinusitis diagnosis and management.


Pharma Focus

Nonsteroidal Anti-inflammatory Drugs

Clinical Trials

Diclofenac Potassium Versus Acetaminophen in Febrile Children with Acute Upper Respiratory Tract Infections

Study Type:Interventional

Age/Gender Requirement:2-6 years (male/female)

Sponsor: Novartis Pharmaceuticals

Purpose:To “assess if a single dose of Diclofenac potassium (0.5 mg/kg) is more or as effective as a single dose of Acetaminophen (10 mg/kg) in the reduction of fever during 2 hours, in the treatment of febrile children with acute upper respiratory infections.”


Acetylsalicylic AcidCombined with Pseudoephedrine in Common Cold

Study Type: Interventional

Age/Gender Requirement: 18 years (male/female)

Sponsor: Bayer

Purpose:To determine the effectiveness of an acetylsalicylic acid (aspirin) pseudoephedrine combination for the treatment of pain and congestion symptoms compared to the effectiveness of the individual components of the medicine and” placebo.


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