This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

NICE guidance - antibiotic prescribing for self-limiting respiratory tract infections

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

A no antibiotic prescribing strategy or a delayed antibiotic prescribing strategy should be agreed for patients with the following conditions:

  • acute otitis media
  • acute sore throat/acute pharyngitis/acute tonsillitis
  • common cold
  • acute rhinosinusitis
  • acute cough/acute bronchitis

Depending on clinical assessment of severity, patients in the following subgroups can also be considered for an immediate antibiotic prescribing strategy (in addition to a no antibiotic or a delayed antibiotic prescribing strategy):

  • bilateral acute otitis media in children younger than 2 years

  • acute otitis media in children with otorrhoea

  • acute sore throat/acute pharyngitis/acute tonsillitis when three or more Centor criteria are present

For all antibiotic prescribing strategies, patients should be given:

  • advice about the usual natural history of the illness, including the average total length of the illness (before and after seeing the doctor):
    • acute otitis media: four days
    • acute sore throat/acute pharyngitis/acute tonsillitis: one week
    • common cold: one and a half weeks
    • acute rhinosinusitis: two and a half weeks
    • acute cough/acute bronchitis: three weeks
  • When the no antibiotic prescribing strategy is adopted, patients should be offered:
    • reassurance that antibiotics are not needed immediately because they are likely to make little difference to symptoms and may have side effects, for example, diarrhoea, vomiting and rash
    • a clinical review if the condition worsens or becomes prolonged
  • When the delayed antibiotic prescribing strategy is adopted, patients should be offered:
    • reassurance that antibiotics are not needed immediately because they are likely to make little difference to symptoms and may have side effects, for example, diarrhoea, vomiting and rash
    • advice about using the delayed prescription if symptoms are not starting to settle in accordance with the expected course of the illness or if a significant worsening of symptoms occurs
    • advice about re-consulting if there is a significant worsening of symptoms despite using the delayed prescription. A delayed prescription with instructions can either be given to the patient or left at an agreed location to be collected at a later date

Updated NICE prescribing guidance has been given with respect to cough, sore throat, sinusitis and otitis media - these are linked.

Reference:


Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.