Learning Objective #1: Describe an evidence-based upper respiratory infection treatment guideline to support appropriate care, without unnecessary risk of the development of antibiotic resistance

Learning Objective #2: Use an evidence-based upper respiratory infection treatment guideline to explain treatment decisions to patients

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One problem that remains significant to nurse practitioners (ANP) and other health care providers is treatment of acute upper respiratory tract infections (URI). Frequently people presenting with URI symptoms request antibiotics. Even among experienced providers there may be difficulty in differentiating instances of necessary versus unnecessary use of antibiotics. The common cold accounts for 40% of URIs; 80 % have antibiotics unnecessarily prescribed. Reviewing research evidence and the trajectory and epidemiology of URIs reveals that incidence decreases with age and women aged 18 to 24 years are 1.5 times more likely than males of that age to have a cold as the cause of the URI. Because of the risk of complications for persons with URI when antibiotics are not appropriately prescribed, stating that antibiotics should not be prescribed for URIs of < 14 days, as some practitioners have asserted, is not a sufficient guideline. On the other hand, stating that there is no evidence to support the beneficial use of alternative treatments such as herbal therapy, antioxidants and zinc in treatment of URI is also unacceptable. Data on symptomatic treatment (throat lozenges, decongestants, antihistamines) and alternative treatments (echinea, zinc, vitamin C, and even chicken soup) are known. The author developed an evidence-based URI treatment guideline to support appropriate care, without unnecessary risk of the development of antibiotic resistance, which can be used to explain treatment decisions to patients. A review of the evidence from Cochrane data bases and current research was used to prepare a one page guideline that includes traditional paths for treatment as well as alternative therapies. Appreciating the impact of treatment choice on quality of life and providing appropriate antibiotic therapy can be the value-added difference of nurse practitioners as providers of primary care. Using evidence as the basis for treatment choice has been crucial.