Publication:

An epidemiological survey to assess the clinical use of cephalosporins in community-acquired respiratory tract infections

Background In outpatient management of respiratory tract infections, the clinicians’ preferences always have  a broad spectrum of antibiotics as an empirical therapy. Clinical use of cephalosporins and fluoroquinolones has been recommended by various international guidelines as a monotherapy or as combination therapy to manage these. This survey was conducted to assess the in-clinic use and preference of cephalosporins or fluoroquinolones as monotherapy or as combination therapy in managing respiratory tract infections by Indian doctors.

Methods A survey questionnaire was drafted to capture the feedback from cross-specialty regarding the preference of using antibiotics in respiratory tract infection in real time clinical settings.

Results Data from 163 physicians were collected and evaluated across India. 79 (48%) clinicians reported pharyngitis/tonsillitis to be the most commonly encountered respiratory tract infection followed by community-acquired pneumonia (CAP) 62 (38%). 100 (61%) clinicians preferred use of cefpodoxime monotherapy as a primary line of treatment for the management of respiratory pharyngitis/tonsillitis. Use of short course therapy (≤1 week) of cefpodoxime and levofloxacin as combination therapy is preferred by 94 (58%) clinicians, in cases of acute exacerbation of chronic bronchitis (AECB) 85 (52%), and CAP 83 (51%). The clinical preference of levofloxacin was observed with only 16 (10%) clinicians, in lower respiratory tract infections, i.e. AECB and CAP.

Conclusion In-clinic use of cefpodoxime as monotherapy is preferred in upper respiratory tract infections. However, clinicians recommend a combination therapy of cefpodoxime and levofloxacin in lower respiratory tract infections.