Upper respiratory tract infections
Upper respiratory tract infections
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DOI：
10.1007/bf02722930
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发表时间：
2001-12-01
影响因子：
4.3
通讯作者：
Kabra, S. K.
中科院分区：
文献类型：
--
作者：
Jain, Neemisha;Lodha, R.;Kabra, S. K.
在综合医院，急性呼吸道感染占门诊病人的20-40%，占住院病人的12-35%。上呼吸道感染包括鼻咽炎、咽炎、扁桃体炎和中耳炎，占呼吸道感染总发作的87.5%。绝大多数急性上呼吸道感染是由病毒引起的。在大多数情况下，普通感冒是由病毒引起的，不需要抗菌剂，除非它并发急性中耳炎伴渗出液、扁桃体炎、鼻窦炎和下呼吸道感染。鼻窦炎通常与普通感冒有关。大多数鼻窦炎是病毒性的，因此，无需抗菌治疗即可自行消退。引起鼻窦炎的最常见的细菌是S。pneumoniae，H. influenzae、M. catarrhalis，卡他沙门氏菌S.金黄色葡萄球菌和化脓阿莫西林是首选抗菌药物。替代药物是头孢克洛或头孢氨苄。如果鼻窦炎是复发性或慢性的，后者成为第一线。急性咽炎通常由病毒引起，不需要抗生素。大约15%的发作可能是由于A组β溶血性链球菌（GABS）。早期开始抗生素治疗GABS引起的咽炎可以预防急性风湿热等并发症。选择的药物是青霉素10-14天。替代药物包括口服头孢菌素（头孢克洛、头孢氨苄）、阿莫西林或大环内酯类。
Acute respiratory infections accounts for 20-40% of outpatient and 12-35% of inpatient attendance in a general hospital. Upper respiratory tract infections including nasopharyngitis, pharyngitis, tonsillitis and otitis media constitute 87.5% of the total episodes of respiratory infections. The vast majority of acute upper respiratory tract infections are caused by viruses. Common cold is caused by viruses in most circumstances and does not require antimicrobial agent unless it is complicated by acute otitis media with effusion, tonsillitis, sinusitis, and lower respiratory tract infection. Sinusitis is commonly associated with common cold. Most instances of rhinosinusitis are viral and therefore, resolve spontaneously without antimicrobial therapy. The most common bacterial agents causing sinusitis are S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus and S. pyogenes. Amoxycillin is antibacterial of choice. The alternative drugs are cefaclor or cephalexin. The latter becomes first line if sinusitis is recurrent or chronic. Acute pharyngitis is commonly caused by viruses and does not need antibiotics. About 15% of the episodes may be due to Group A beta hemolytic streptococcus (GABS). Early initiation of antibiotics in pharyngitis due to GABS can prevent complications such as acute rheumatic fever. The drug of choice is penicillin for 10-14 days. The alternative medications include oral cephalosporins (cefaclor, cephalexin), amoxicillin or macrolides.