Judicious use of antibiotics for common pediatric respiratory infections

Pediatr Infect Dis J. 2000 Sep;19(9):938-43. doi: 10.1097/00006454-200009000-00038.


Background: Antibiotic resistance among common respiratory infection-producing bacteria such as Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis has become a major global public health problem. The use of antibiotics, whether or not medically justified for a particular illness, contributes to the development of resistant bacteria. To help to contain the proliferation of drug-resistant bacteria, members of the CDC and the American Academy of Pediatrics (AAP) recently published principles for the judicious use of antibiotics in common pediatric respiratory infections including the common cold, otitis media, sinusitis and tonsillopharyngitis. This article reviews the CDC/AAP principles for management of these illnesses and describes results of clinical practice studies in which efforts to improve the judicious use of antibiotics were undertaken.

Conclusions: The success of the CDC/AAP principles in containing the increase in antimicrobial resistance depends upon their being practiced. Results of clinical practice studies indicate that judicious use of antimicrobial therapy in pediatric respiratory infections can be realized through education and persistence. More widespread educational and behavior modification efforts are necessary to reduce unnecessary prescription of antibiotics and to curtail the still burgeoning problem of bacterial resistance.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Behavior Therapy
  • Child
  • Child, Preschool
  • Clinical Trials as Topic
  • Drug Administration Schedule
  • Drug Resistance, Microbial*
  • Female
  • Guideline Adherence
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Otitis Media / drug therapy*
  • Patient Education as Topic
  • Pharyngitis / drug therapy*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Sinusitis / drug therapy*
  • Tonsillitis / drug therapy*


  • Anti-Bacterial Agents