Community-acquired upper respiratory tract infections and the role of third-generation oral cephalosporins

Abstract

Common community-acquired infections include those of the upper respiratory tract. In the 1990s, the antimicrobial treatment of upper respiratory tract infections focused on penicillin-resistant Streptococcus pneumoniae. However, following the introduction of a pneumococcal conjugate vaccine, a decrease in invasive pneumococcal disease occurred, and in the case of otitis media a shift towards Haemophilus influenzae as the predominant causative pathogen was observed. Future antimicrobial therapy for outpatient upper respiratory tract infections may need to focus on pathogens such as penicillin-susceptible S. pneumoniae, β-lactamase-producing H. influenzae, β-lactamase-negative amoxicillin-resistant H. influenzae and Moraxella catarrhalis. In these circumstances, third-generation oral cephalosporins, such as cefixime and cefdinir, could be increasingly used as an optional first-line therapy in community practice for upper respiratory tract infections suspected to be caused by these key pathogens, as an alternative to amoxicillin–clavulanate.

Keywords::

• amoxicillin–clavulanate
• cefdinir
• cefixime
• cephalosporins
• community-acquired infections
• otitis media
• pneumococcal conjugate vaccine
• upper respiratory tract infections

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Editorial assistance was kindly provided by Katherine Croom and ContentEdNet, which was funded by Astellas Pharma (Japan). No other writing assistance was utilized in the production of this manuscript.