From the Research
Upper respiratory tract infections (URTIs) typically do not require hospital admission unless complications or severe symptoms are present, and management should focus on supportive care and risk assessment. Admission is generally recommended for patients with respiratory distress, inability to maintain oral hydration, immunocompromised status, or significant comorbidities that increase risk. Most URTIs can be managed at home with supportive care including rest, adequate hydration, and over-the-counter medications like acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) or ibuprofen (400-600mg every 6-8 hours with food) for fever and pain relief, as suggested by 1. Saline nasal sprays and humidifiers can help relieve congestion.
Antibiotics are not recommended for viral URTIs, which constitute about 90% of cases. However, if bacterial infection is suspected (persistent symptoms beyond 10 days, high fever, purulent discharge), azithromycin 500mg for 5 days may be prescribed for adults, as shown to be effective in a real-world setting by 2. Patients should seek immediate medical attention if experiencing severe shortness of breath, persistent high fever, altered mental status, or inability to drink fluids. The decision for admission ultimately depends on clinical assessment of symptom severity, patient's ability for self-care, and risk factors for complications.
Key considerations in managing URTIs include:
- Symptom severity and duration
- Patient's ability for self-care
- Risk factors for complications, such as immunocompromised status or significant comorbidities
- Appropriate use of antibiotics, such as azithromycin, when bacterial infection is suspected
- Supportive care measures, including rest, hydration, and over-the-counter medications for symptom relief. It's also important to note that oxygen therapy should be used judiciously, as it may increase the risk of infection for healthcare workers, as highlighted by 3.