From the Research
Patients with upper respiratory tract infections (URTIs) should be admitted to the hospital if they present with severe symptoms or complications that cannot be managed safely at home, such as respiratory distress, hypoxemia, or significant comorbidities that increase risk. Admission criteria for URTIs include:
- Respiratory distress (respiratory rate >30 breaths/minute)
- Hypoxemia (oxygen saturation <92% on room air)
- Inability to maintain oral hydration
- Altered mental status
- Significant comorbidities that increase risk (such as immunocompromise, chronic lung disease, or heart failure)
- Evidence of spreading infection (such as peritonsillar abscess or retropharyngeal abscess)
- Epiglottitis
- Severe stridor requiring airway management Patients with URTIs who are elderly, very young, or have failed outpatient therapy should also be considered for admission 1. Once admitted, treatment typically includes respiratory support (supplemental oxygen if needed), intravenous fluids for hydration, appropriate antimicrobial therapy based on the suspected pathogen, antipyretics for fever, and close monitoring of vital signs and respiratory status 2. Hospital admission allows for more intensive treatment and monitoring to prevent progression to lower respiratory tract involvement or other complications, particularly in high-risk individuals where URTIs can rapidly deteriorate into more serious conditions like pneumonia or respiratory failure. It is essential to note that the effectiveness of management strategies for URTIs is highly increased with early intervention, administered prior to the peaking of viral shedding 2. Additionally, mucoadhesive gel nasal sprays have shown promising results for early intervention of acute URTI, acting by creating a barrier that can trap virus particles and delivering broad spectrum activity against a wide variety of pathogens that cause acute URTI 2. The management of URTIs should be tailored to the individual patient's symptoms and preferences, taking into account the limited utility of antibiotics and the numerous pharmacologic options for symptom relief 1.