APPROPRIATE USE OF ANTIBIOTICS FOR URIS IN CHILDREN - PART II - COUGH, PHARYNGITIS AND THE COMMON GOLD

This article summarizes the principles of judicious antimicrobial ther apy for three of the five conditions-cough, pharyngitis, the common co ld-that account for most of the outpatient use of these drugs in the U nited States. The principles governing the other two conditions, otiti s media and acute sinusitis, were presented in the previous issue. Thi s article summarizes evidence against the use of antibiotic treatment for illness with cough or bronchitis in children, unless the cough is prolonged. Although empiric treatment maybe started in patients With p haryngitis when streptococcal infection is suspected the authors recom mend withholding antibiotic treatment until antigen testing or culture is positive. There is never any indication for antibiotic treatment o f the common com; it is important to understand the natural history of colds, because symptoms such as mucopurulent rhinitis or cough, even when they persist for up to two weeks, do not necessarily indicate bac terial infection.