In general, antibiotic therapy for winter diseases should be considered in people with a known or possible bacterial infection and at high risk of developing systemic complications. This includes those who are systemically very ill, young infants, frail elderly or those with comorbid diseases such as immunosuppression, diabetes, or significant heart, lung, kidney, liver, or neuromuscular disease. People with a history of hospitalization and children who give birth prematurely are also often at high risk. Antibiotic therapy is indicated for people with the following infections:
Antibiotics should be given within three weeks of the onset of cough (or unknown onset or pregnant women) and in high-risk contacts, for example babies <1 year old, pregnant women, to reduce transmission. Antibiotics will not change the course of the disease unless they are given in the first few days of infection.
Antibiotics are suitable for all people with suspected pneumonia. In some cases, antibiotic therapy may be appropriate for people with the following infections.
Acute Middle Ear Inflammation
Antibiotics are often unnecessary, as the infection will resolve without treatment. Antibiotics may be considered for children with systemic or severe symptoms, perforation and / or tinnitus, children who do not improve after 48 hours, infants under six months of age, or infants under two years of age with bilateral infections. Antibiotics should also be considered for children with persistent or recurrent infections (3 infections at 6 months or 4 infections at 12 months).
Antibiotic treatment is unnecessary unless Group A Streptococcus (GAS) is positive and there is a high risk of rheumatic fever (personal, family or household history of rheumatic fever, or two or more of the following: Mityori or Pacific ethnicity, age 3-35 years, living crowded / low socioeconomic conditions) or severe or systemic symptoms, eg. quinsy, severe inflammation, scarlet fever.
Antibiotic therapy is often unnecessary, as most infections are viral and self-limiting. Intranasal corticosteroids and nasal saline irrigation may be helpful. 7 Antibiotics may be considered for people who have had symptoms for more than 10 days or have severe symptoms, eg fever> 39 ° C, facial pain lasting 3 days, worsening symptoms.
Bronchiolitis is a lower respiratory tract infection usually caused by a respiratory virus, so it is not treated with antibiotics. It typically affects children under 12 months of age. The possibility of this infection should be considered in young children with respiratory symptoms.
What Makes Decisions About Antibiotic Use Difficult?
Winter sickness can present a challenge to clinicians in primary health care, as the decision to prescribe or not to antibiotics is complicated by factors such as:
• Difficulty in distinguishing between a bacterial or viral infection; symptoms and signs may not provide reliable differentiation, point of care testing is not widely available and does not always provide a clear answer
Concern about missing a diagnosis where antibiotics are required, such as bacterial pneumonia
Determining which patients will benefit most from antibiotics or who may deteriorate in the absence of antibiotics, as not all patients with bacterial infections require antibiotic treatment.
• If an antibiotic is indicated and not prescribed at the initial presentation, it is the question of whether the patient can return for an immediate follow-up assessment if the patient’s symptoms worsen.
It is important that people are not discouraged from accidentally seeking medical help when they become ill by giving negative messages about antibiotic use. Anxiety is one of the main emotions that drive the use of antibiotics. This includes both the patient’s anxiety about not feeling well and not knowing what’s wrong with them, and the clinician’s willingness not to miss something very important and to do his best for the patient.
Anxiety can reduce understanding of issues and lead to poor decision making for both patients and clinicians. Clear communication, providing symptomatic treatment advice, and emergency planning are essential components of a non-antibiotic approach to managing winter diseases. For many people, if antibiotics aren’t prescribed, it means they don’t really get sick. It is important to validate the patient’s decision to seek treatment and explain that viral infections can make people feel as uncomfortable as bacterial infections.
Treatments For Children
Because there are limited options for managing winter sickness symptoms in children, caregivers may want to try alternative treatments. There is some evidence that a teaspoon of honey before bedtime can improve the frequency and severity of cough in children; Due to the risk of botulism, 20 honey is not recommended for children under one year old. The aromatic vapor scrub applied before bedtime can improve sleep for children and therefore their parents. 21NB Steam lotions contain essential oils that can irritate the skin.
If this is a problem, the products are available specifically for children with less irritants, or alternatively apply the product to a handkerchief or handkerchief and place it in a pajama pocket, inside a pillowcase, or under sheets (small children’s access).
Healthcare professionals should give patients unbiased, evidence-based advice (if available) about treatments they use or want to try. Discuss the benefits or shortcomings and possible harms. The patient should be reminded that most winter diseases are brief and will resolve without treatment.
Prevention of Infection
Steps that patients and caregivers can take to reduce the risk of contraction or spread of upper respiratory and ear infections in winter include:
• Hand washing to reduce the risk of contracting or spreading infection; Washing with soap and water is sufficient and is more effective than alcohol handwashing at preventing the spread of flu.
Covering the mouth or nose when coughing or sneezing
Flu and pneumococcal vaccine
• Smoking should be quit since smoking is a risk factor for respiratory infections.
• A healthy home environment such as a warm, dry, smoke-free home, warm clothes and good nutrition should be prepared.
Author: Ozlem Guvenc Agaoglu