Antibiotics and upper respiratory tract infection

F Y T Lau 劉鈺棠

Dear Editor,

I have read with great interest the article by Prof Y T Wun in your January 2001 issue.

Prof Wun reiterated that the abusive use of antibiotics in upper respiratory tract infection (URTI) is uncalled for.

We all treat URTI as a pure viral infection and therefore as such the use of antibiotics in whatever form.

However, during the course of URTI, secondary bacterial infection frequently occurs necessitating the use of an appropriate antibiotic. However this practice is not absolute, because the secondary bacterial infection may have been precipitated by the breakdown of the natural body defence mechanism that normally maintains a healthy mucosal service.

The drainage of the sinuses is essential to maintain health. Attention has to be paid to re-establish this drainage system during URTI. Secondary bacterial infection will resolve, but it will take a little bit longer without antibiotics. If you are prepared to wait a little bit longer, an antibiotic is not necessary.

When a patient comes to you for an URTI, it is your duty as a doctor to convince the patient about the management of URTI and that it is your conviction that antibiotics are not necessary. If you are unable to uphold your conviction in the management of URTI, you have the same problems in other areas in convincing your patient to accept your management.

Prescribe antibiotics judiciously and not haphazardly. Do not prescribe antibiotics if you think it is not necessary. Do not prescribe an alternative with the least undesirable effect.

Stand your grounds on principle.

F Y T Lau, FHKAM(Family Medicine)
Family Physician in Private Practice