Skip to main content
Springer Nature - PMC COVID-19 Collection logoLink to Springer Nature - PMC COVID-19 Collection
. 2001;68(12):1135–1138. doi: 10.1007/BF02722930

Upper respiratory tract infections

Neemisha Jain 1, R Lodha 1, S K Kabra 1
PMCID: PMC7091368  PMID: 11838568

Abstract

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 areS. pneumoniae, H. influenzae, M. catarrhalis,S. aureus andS. 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.

Key words: Upper respiratory tract infections, Pharyngitis, Sinusitis, Nasopharyngitis

References

  • 1.Manmohan, Bhargava SK. Acute respiratory infection.Indian Pediatr 1984; 211–213. [PubMed]
  • 2.Chhabra P, Garg S, Mittal SK, et al. Magnitude of acute respiratory infection in under five. Indian Pediatr. 1993;30:1315–1319. [PubMed] [Google Scholar]
  • 3.Tambe MP, Sivaraman C, Chandrashekhar Y. Acute respiratory infection in Children-a survey in the rural community. Indian J Med Science. 1999;53:249–253. [PubMed] [Google Scholar]
  • 4.Jain A, Pande PK, Mishra A, et al. An Indian hospital study of viral causes of acute respiratory infections in children. J Med Microbiol. 1991;35:219–223. doi: 10.1099/00222615-35-4-219. [DOI] [PubMed] [Google Scholar]
  • 5.Dowell SF, Schartz B. Resistant pneumococci: protecting patients through judicious antibiotic use. Am Fam Physician. 1997;15:1647–1654. [PubMed] [Google Scholar]
  • 6.Rosestein N, Phillips WR, Gerber MA, et al. The common coldprinciples of judicious use of antimicrobial agents. Pediatrics. 1998;101:181–184. [Google Scholar]
  • 7.Dowell SF, Marcy M, Phillips WR, et al. Principles of judicious use of antimicrobial agents for pediatric upper respiratory infections. Pediatrics. 1998;101:163–165. [Google Scholar]
  • 8.O’Brien KL, Dowell SF, Scharwtz B, et al. Acute sinusitisprinciples of judicious use of antimicrobial agents. Pediatrics. 1998;101:174–177. doi: 10.1542/peds.101.6.e6. [DOI] [Google Scholar]
  • 9.Schwartz B, Marcy SM, Phillips WR, et al. PharyngitisPrinciples of judicious use of antimicrobial agents. Pediatrics. 1998;101:171–174. doi: 10.1542/peds.101.3.479. [DOI] [Google Scholar]
  • 10.Wald ER, Dashefsky B, Byers C, et al. Frequency and severity of infections in daycare. J Pediatr. 1988;112:540–546. doi: 10.1016/S0022-3476(88)80164-1. [DOI] [PubMed] [Google Scholar]
  • 11.Turner TB. The epidemiology, pathogenesis, and treatment of the common cold. Semin Pediatr Infect Dis. 1995;6:57–61. doi: 10.1016/S1045-1870(05)80052-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Ashes MI. Infections of the upper respiratory tract. In: Taussig LM, Landau LI, editors. Pediatric Respiratory Medicine. Missouri: Mosby Inc; 1999. pp. 530–547. [Google Scholar]
  • 13.Horn ME, Brain E, Gregg I, et al. Respiratory viral infection in childhood. A survey in general practice, Rohanpton. 1967–1972. J Hyg. 1975;74:157–168. doi: 10.1017/s0022172400024220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Gadomski AM. Potential intervention for preventing pneumonia among young children : lack of effect of antibiotic treatment for upper resiratory infections. Pediatr Infect Dis J. 1993;12:115–120. doi: 10.1097/00006454-199302000-00002. [DOI] [PubMed] [Google Scholar]
  • 15.Todd JK, Todd N, Damato J, et al. Bacteriology and treatment of purulent nasopharyngitis: a double blind, placebo controlled evaluation. Pediatr Infect Dis J. 1984;3:226–232. doi: 10.1097/00006454-198405000-00009. [DOI] [PubMed] [Google Scholar]
  • 16.Jackson GG, Dowling HF, Huldoon RL. Present concepts of the common cold. Am J Public Health. 1962;52:940–945. doi: 10.2105/ajph.52.6.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Cloutier MM. The coughing child. Etiology and treatment of a common symptom. Postgrad Med. 1983;73:169–175. doi: 10.1080/00325481.1983.11697802. [DOI] [PubMed] [Google Scholar]
  • 18.Cherry JD, Newman A. Sinusitis. In: Feigin RD, Cherry JD, editors. Textbook of Pediatric Infectious Diseases. 4th edn. Philadelphia, PA: WB Saunders; 1998. pp. 183–192. [Google Scholar]
  • 19.Gwaltney J, Phillips C, Miller R, et al. Computed tomographic study of the common cold. N Eng J Med. 1994;330:25–30. doi: 10.1056/NEJM199401063300105. [DOI] [PubMed] [Google Scholar]
  • 20.Giebink GS. Childhood sinusitis; pathophysiology, diagnosis and treatment. Pediatr Infect Dis J. 1994;13:S55–S65. [PubMed] [Google Scholar]
  • 21.Doern GV. Resistance among problem respiratory pathogens in pediatrics. Pediatr Infect Dis J. 1995;104:462–463. doi: 10.1097/00006454-199505001-00003. [DOI] [PubMed] [Google Scholar]
  • 22.Wald E. Sinusitis in children. N Eng J Med. 1992;326:319–323. doi: 10.1056/NEJM199201303260507. [DOI] [PubMed] [Google Scholar]
  • 23.Cherry JD. Pharyngitis (Pharyngitis, tonsillitis, tonsillopharyngitis, and nasopharyngitis) In: Feigin RD, Cherry JD, editors. Text-Book of Pediatric Infectious Diseases. 4th edn. Philadelphia, PA: WB Saunders; 1998. pp. 148–156. [Google Scholar]
  • 24.Tanz RR, Shulman ST. Diagnosis and treatment of Group A streptococcal pharyngitis. Semin Pediatr Infect Dis. 1995;6:69–78. doi: 10.1016/S1045-1870(05)80054-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Rammelkamp CH. Rheumatic heart disease-a challenge. Circulation. 1958;17:842–851. doi: 10.1161/01.cir.17.5.842. [DOI] [PubMed] [Google Scholar]
  • 26.American Academy of Pediatrics . Group A streptococcal infections. In: Peter G, editor. 1997 Red Book Report of The Committee on Infectious Diseases. 24th edn. Elk Grove Village, IL: American Academy of Pediatrics; 1997. pp. 83–94. [Google Scholar]
  • 27.Pichichero ME, Disney FA, Green JL, et al. Adverse and beneficial effects of immediate treatment of group A-betahemolytic streptococcal pharyngitis with penicillin. Pediatr Infect Dis. 1987;6:635–643. doi: 10.1097/00006454-198707000-00004. [DOI] [PubMed] [Google Scholar]
  • 28.Pichichero ME, Margolis PA. Comparison of cephalosporin and penicillins in the treatment of group A beta-hemolytic streptococcal pharyngitis: a metaanylysis supporting the concept of microbial copathogenicity. Pediatr Infect Dis J. 1991;10:275–281. doi: 10.1097/00006454-199104000-00002. [DOI] [PubMed] [Google Scholar]
  • 29.Jacobs RF. Judicious use of antibiotics for common pediatric respiratory infections. Pediatr Infect Dis J. 2000;19:938–943. doi: 10.1097/00006454-200005001-00008. [DOI] [PubMed] [Google Scholar]

Articles from Indian Journal of Pediatrics are provided here courtesy of Nature Publishing Group

RESOURCES