Treatment of Viral Respiratory Infections

Approximately 80% of adults with acute bronchitis receive a prescription for antibiotics; yet most bronchitis is due to viral infection for which antibiotic therapy offers no benefit and should be avoided.

Unnecessary use of antibiotics poses significant risk, contributing to (1) an increase in antimicrobial-resistant bacteria, and (2) side effects and adverse outcomes for patients, including the increasing and serious complication of Clostridium difficile  infection.  

The physician's and patient's mutual goal of safe and effective care is best achieved with a well-educated and informed patient population. Patients are more receptive to not receiving a prescription for antibiotics when their health care providers do the following:

• Validate their patients' concerns
• Acknowledge the discomfort caused by viral illness
• Provide specific recommendations for symptom relief

Tools

• Sample Bronchitis Algorithm (.pdf, 1 page)
• Sample Sinusitis Protocol (.pdf, 1 page)
• Sample OTC Prescription Pad (.pdf, 1 page)
• CDC Sample Symptom Relief Prescription (.pdf, 1 page)
• Tips for Talking with Patients with Viral Respiratory Infections - Improving Patient Satisfaction When Antibiotics Are Not Indicated (.pdf, 1 page)
• Colds, Flu and Bronchitis: Treatment and Care patient handout (.pdf, 2 pages)
• Posters for Waiting/Exam Rooms
  • Antibiotics Don't Work on a Cold Poster (.pdf, 1 page)
  • Antibiotics Are Ineffective Against the Flu Poster (.pdf, 1 page)

Resources

• CDC Get Smart about Antibiotics 
• TV Commercial: Antibiotics Can't Treat Viral Infections 
• Massachusetts Department of Public Health 
• MMS Patient Page Colds, Flu and Viruses
• Preventing Clostridium difficile Infections (MMWR March 6, 2012)

This campaign is based on the guiding principles of an expert panel organized by the Centers for Disease Control and Prevention with representatives from the American Academy of Family Physicians, the American College of Physicians, and the Infectious Disease Society of America (Annals of Internal Medicine 2001;134:479-529). This information is not a substitute for a credentialed provider's experience and education. When treating any patient, please use your own independent medical judgment.

Supporters of this project include the Massachusetts Medical Society, the Massachusetts Department of Public Health, the Massachusetts Association of Health Plans, the Partnership for Healthcare Excellence, the Massachusetts Hospital Association, and Blue Cross Blue Shield of Massachusetts.