- URIs are among the leading causes of lost time from work or school.
- Distinguishing pts with primary viral URI from those with primary bacterial URI is difficult since the signs and symptoms are the same.
- URIs are often treated with antibiotics even though bacteria cause only 25% of cases. Inappropriate prescribing of antibiotics for URIs is a leading cause of antibiotic resistance in common community-acquired pathogens such as Streptococcus pneumoniae.
- Definition: Nonspecific URIs (the “common cold”) have no prominent localizing features.
- Etiology: A wide variety of viruses (e.g., rhinoviruses, coronaviruses, parainfluenza viruses, influenza viruses, adenoviruses) can cause nonspecific URIs.
- Clinical manifestations: an acute, mild, self-limited catarrhal syndrome, typically characterized by rhinorrhea, nasal congestion, cough, and sore throat
- Hoarseness, malaise, sneezing, and fever are more variable.
- The median duration of symptoms is ∼1 week (range, 2-10 days). Cough secondary to upper respiratory inflammation may last 2-3 weeks and does not necessarily indicate a need for antibiotics.
- Secondary bacterial infections complicate 0.5-2% of colds and are associated with a prolonged course and/or increased severity of illness, often with localization of signs and symptoms. Purulent nasal and throat secretions are poor predictors of bacterial infection.
- Treatment: Symptom-based treatment (e.g., with decongestants, NSAIDs) is typically all that is required. Antibiotics are not indicated.