ONCE again the season of respiratory tract infections is upon us, and the physician must decide which antibiotic should be administered and when. Dr. Mark H. Lepper1 reminds us that the overwhelming majority of respiratory infections are viral and not affected by antibiotics. From 2% to 5% are due to group A β-hemolytic streptococcus, and these not only respond to antibiotic treatment, but such treatment is mandatory to prevent the two serious complications that may follow: rheumatic fever and nephritis. Only by culture can streptococcal sore throat be differentiated with certainty from viral pharyngitis; although the presence of leukocytosis is in favor of the former. Penicillin continues to be the antibiotic of choice for streptococcal pharyngitis with erythromycin or the newer lincomycin as alternatives for patients with a history of penicillin sensitivity.
Pneumococcus accounts for about 1% of respiratory tract illness and responds to antibiotic therapy when culture reveals
Antibiotics in Respiratory Tract Infections. Arch Otolaryngol. 1965;82(6):565–566. doi:10.1001/archotol.1965.00760010567001
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