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[Antimicrobial use in acute upper respiratory infections in family medicine].

Acute upper respiratory infections are one of the main causes of office visits in family practice worldwide. If antimicrobial drugs were used judiciously, it is estimated that 50 million of these prescriptions could be avoided. The vast majority of acute rhinopharyngitis (common cold) and acute sinusitis cases are resolved without using antibiotics. Acute otitis media must be distinguished from otitis media with effusion: the former may be successfully treated, in many cases, without prescribing antibiotics, while the latter does not improve with antimicrobial drug use unless its evolution was > 3 months. Acute pharyngitis is better treated if considered as an odynophagia syndrome, employing clinical criteria to distinguish cases that need antimicrobial drug prescription. Acute bronchitis does not improve significantly by utilizing antimicrobial drugs. Drugs from the quinolones group are not a choice for treating acute upper respiratory infections.