Adult Treatment Recommendations
The table below summarizes the most recent recommendations for appropriate antibiotic prescribing for adults seeking care in an outpatient setting. Antibiotic prescribing guidelines establish standards of care and focus quality improvement efforts.
The table also offers information related to over-the-counter medication for symptomatic therapy. Over-the-counter medications can provide symptom relief, but have not been shown to shorten the duration of illness. They also have a low incidence of minor adverse effects. Providers and patients should weigh the potential for benefits and minor adverse effects when considering symptomatic therapy.
||If a bacterial infection is established:
|Acute uncomplicated bronchitis3–5||
||Routine treatment of uncomplicated acute bronchitis with antibiotics is not recommended, regardless of cough duration.
Options for symptomatic therapy include:
Evidence supporting specific symptomatic therapies is limited.
|Common cold or non-specific upper respiratory tract infection (URI)6,7||
Providers and patients must weigh the benefits and harms of symptomatic therapy.
|Acute uncomplicated cystitis10,11||
||For acute uncomplicated cystitis in healthy adult non-pregnant, premenopausal women:
- Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (updated): adult sinusitisExternal. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1-39.
- Chow AW, Benninger MS, Itzhak B, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adultsExternal. Clin Infect Dis. 2012;54(8):e72-e112.
- Albert RH. Diagnosis and treatment of acute bronchitisExternal. Am Fam Physician. 2010;82(11):1345-50.
- Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough: ACCP evidence-based clinical practice guidelinesExternal. Chest. 2006;129(1 Suppl).
- Gonzales R, Bartlett JG, Besser RE, et al. Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: BackgroundExternal. Ann Intern Med. 2001;134(6):521-9.
- Fashner J, Ericson K, Werner S. Treatment of the common cold in children and adultsExternal. Am Fam Physician. 2012;86(2):153-9.
- Pratter MR. Cough and the common cold: ACCP evidence-based clinical practice guidelinesExternal. Chest. 2006;129(1 Suppl): 72S-74S.
- Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of AmericaExternal. Clin Infect Dis. 2012;55(10):e86-102.
- Cooper RJ, Hoffman JR, Bartlett JG, et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: BackgroundExternal. Ann Intern Med. 2001;134(6):509-17.
- Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious DiseasesExternal. Clin Infect Dis. 2011;52(5):e103-20.
- Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitisExternal. Am Fam Physician. 2011;84(7):771-6.