tailieunhanh - Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other Upper Respiratory Tract Infections (Part 2)

Upper Respiratory Infections: Treatment Antibiotics have no role in the treatment of uncomplicated nonspecific URI. In the absence of clinical evidence of bacterial infection, treatment remains entirely symptom-based, with use of decongestants and nonsteroidal antiinflammatory drugs. Other therapies directed at specific symptoms are often useful, including dextromethorphan for cough and lozenges with topical anesthetic for sore throat. Clinical trials of zinc, vitamin C, echinacea, and other alternative remedies have revealed no consistent benefit for the treatment of nonspecific URI. Infections of the Sinus Sinusitis refers to an inflammatory condition involving the four paired structures surrounding the nasal cavities. . | Chapter 031. Pharyngitis Sinusitis Otitis and Other Upper Respiratory Tract Infections Part 2 Upper Respiratory Infections Treatment Antibiotics have no role in the treatment of uncomplicated nonspecific URI. In the absence of clinical evidence of bacterial infection treatment remains entirely symptom-based with use of decongestants and nonsteroidal antiinflammatory drugs. Other therapies directed at specific symptoms are often useful including dextromethorphan for cough and lozenges with topical anesthetic for sore throat. Clinical trials of zinc vitamin C echinacea and other alternative remedies have revealed no consistent benefit for the treatment of nonspecific URI. Infections of the Sinus Sinusitis refers to an inflammatory condition involving the four paired structures surrounding the nasal cavities. Although most cases of sinusitis involve more than one sinus the maxillary sinus is most commonly involved next in frequency are the ethmoid frontal and sphenoid sinuses. Each sinus is lined with a respiratory epithelium that produces mucus which is transported out by ciliary action through the sinus ostium and into the nasal cavity. Normally mucus does not accumulate in the sinuses which remain sterile despite their adjacency to the bacterium-filled nasal passages. When the sinus ostia are obstructed however or when ciliary clearance is impaired or absent the secretions can be retained producing the typical signs and symptoms of sinusitis. The retained secretions may become infected with a variety of pathogens including viruses bacteria and fungi. Sinusitis affects a tremendous proportion of the population accounts for millions of visits to primary care physicians each year and is the fifth leading diagnosis for which antibiotics are prescribed. It is typically classified by duration of illness acute vs. chronic by etiology infectious vs. noninfectious and when infectious by the offending pathogen type viral bacterial or fungal . Acute Sinusitis Acute sinusitis