ABSTRACT
In the UK, patients with respiratory tract infections (RTI) account for over 40% of antibiotic prescriptions in primary care.1 However, these patients generate a small percentage of specimens submitted to the laboratory. Certain organisms such as Streptococcus pneumoniae and Haemophilus influenzae are recognized as common bacterial pathogens and can cause disease in sites such as the eye, middle ear, and lung, enabling antibiotic guidelines to specify a fairly narrow range of agents to use in empirical treatment. Key to treatment is the use of established guidelines that provide logical steps that determine the need for antibiotics, including ‘no antibiotic’, ‘delayed antibiotic’, or ‘immediate antibiotic’ prescription regimes.2 Added to this is a flow diagram that can be used in assessing the adult patient with communityacquired pneumonia (CAP), including use of the CRB-65 score to decide whether or not the patient requires hospital admission. If this is the case, immediate administration of an antibiotic should be considered.3,4
The main learning points of this chapter are: • The use of guidelines to assess each patient,
and when to consider empirical antibiotic prescription. In general, microbiology specimens for the culture of bacteria are infrequently helpful in management of acute RTI.
