Acute bacterial upper respiratory tract infection Acute upper respiratory tract infection is the most common community-acquired infection, mostly caused by viruses such as rhinovirus, coronavirus, influenza virus, parainfluenza virus, adenovirus, etc. The course of the disease is self-limiting and can be cured without the use of antibacterial drugs and with symptomatic treatment. However, a small number of patients can be bacterial infections or secondary bacterial infections based on viral infections, which can be treated with antibacterial therapy. Acute bacterial pharyngitis and tonsillitis The presence of exudate from the tonsils, enlarged cervical lymph nodes, and fever with elevated peripheral blood leukocytes and neutrophils can help in the clinical diagnosis of bacterial infection. If the patient has developed a scarlet fever-like rash or has a peri-tonsillar abscess, bacterial infection may be diagnosed. The pathogenic bacteria of acute bacterial pharyngitis and tonsillitis are mainly group A beta-hemolytic streptococci, and a few are group C or G beta-hemolytic streptococci. Treatment principles 1, for β-hemolytic streptococcal infection selection of antibacterial drugs. 2, before the administration of drugs to take a pharyngeal swab culture, if possible to do rapid antigen detection test (RADT) as an auxiliary pathogen diagnosis. 3. Since non-suppurative complications – rheumatic fever and glomerulonephritis – can occur after Streptococcus haemolyticus infection, antibacterial treatment is aimed at removing bacteria from the lesion, and the course of treatment takes 10 days. Pathogenic treatment 1. Penicillin is preferred, and penicillin G can be used, or intramuscular procaine penicillin or oral penicillin V, or oral amoxicillin, all for a course of 10 days. In some patients with poor compliance, it is expected that it is difficult to complete the 10-day course of treatment, can be given benzathine penicillin single dose intramuscular injection. 2. Patients with penicillin allergy can take erythromycin and other macrolides orally for 10 days. 3, other optional drugs are oral first or second generation cephalosporins, a course of 10 days, but can not be used for patients with a history of penicillin allergic shock. In addition, sulfonamides are not easy to clear the pharyngeal bacteria, and group A hemolytic streptococci are often resistant to tetracyclines, both of which should not be used. Acute bacterial otitis media Viral upper respiratory tract infections can be combined with mild otitis media manifestations and do not require antibiotics. However, if the manifestation is acute ear pain, hearing loss, fever, progressive tympanic membrane congestion and bulging, or if the tympanic membrane is perforated with fluid, the clinical diagnosis of acute bacterial otitis media should be considered and antibacterial treatment can be given. The pathogenic bacteria of acute bacterial otitis media are Streptococcus pneumoniae, Haemophilus influenzae and Cattamora, which account for about 80% of the pathogens, and a few of them are group A hemolytic streptococci and Staphylococcus aureus. Treatment principles 1, antibacterial therapy should cover Streptococcus pneumoniae, Haemophilus influenzae and Katamora. 2.The course of treatment should be 7 to 10 days to reduce recurrence. 3. Specimens should be taken for bacterial culture and drug sensitivity test when there is exudate in the middle ear. Pathogenic treatment 1. Oral amoxicillin is appropriate for initial treatment. If local Haemophilus influenzae and Catamorium β-lactamase-producing strains are common, amoxicillin/clavulanic acid can also be used orally. 2, other optional drugs are compound sulfamethoxazole and the first generation, the second generation of oral cephalosporins. 3, penicillin allergic patients except for those with a history of penicillin anaphylaxis, can be used with caution when there are indications for the use of cephalosporins. Acute bacterial sinusitis Acute bacterial sinusitis is often secondary to viral upper respiratory tract infections, with involvement of the maxillary sinus being the most common. The pathogenic bacteria are Streptococcus pneumoniae and Haemophilus influenzae, which account for more than 50% of the pathogens; Katamora in adults and children each account for about 10% and 20% of the pathogens; there are still a few anaerobic bacteria, Staphylococcus aureus, Streptococcus pyogenes and other gram-negative bacilli. Treatment principles 1, the initial treatment is appropriate to use antibacterial drugs that can cover Streptococcus pneumoniae, Haemophilus influenzae and Katamora. After the results of bacterial culture and drug sensitivity test are known, adjust them if necessary. 2.Topical vasoconstrictors are used to facilitate drainage of pus from the sinuses. 3.Course of treatment for 10 to 14 days to reduce recurrence. Pathogenic treatment The selection of antibacterial drugs is the same as that for acute bacterial otitis media.