The emergence of drug-resistant pathogens, especially Streptococcus pneumon
iae and Haemophilus influenzae, has complicated empiric treatment of both u
pper and lower respiratory tract infections. Clinicians are now forced to r
eevaluate their choices of first-line antibiotics. Although some bacterial
respiratory infections may resolve spontaneously, the use of antibiotics ha
s demonstrated a faster resolution of symptoms and prevention of sequelae a
nd recurrences, thereby improving the patient's quality of life and ability
to function. Therefore, it is recommended that all diagnosed bacterial res
piratory infections be treated with an antibiotic. Factors that clinicians
need to consider in prescribing an antibiotic are the predominant causative
pathogens, rates of pathogen resistance, patient history, the bacteriologi
c and clinical efficacy, safety profile, dosing regimen, and cost effective
ness of available antibiotic choices.