Antibiotics in Acute Respiratory Infections

In the absence of clear research‐based guidelines, this paper gives practical empirical directions for deciding when to prescribe antibiotics in acute respiratory infections, and how not to prescribe them when their use is inappropriate. Antibiotics probably have no effect on the outcome of most respiratory infections, viral or bacterial. When even the small chance of benefit seems to outweigh the risks and disadvantages, penicillin remains the best first‐line agent for most respiratory infections, owing to the range of pathogenic bacteria likely to be encountered and its low side effect profile. Convincing some patients that antibiotics are not necessary is a sometimes difficult, but worthwhile task.