Middleton D B
St. Margaret Memorial Hospital, Pittsburgh, Pennsylvania.
Am Fam Physician. 1991 Nov;44(5 Suppl):33S-40S, 46S-47S.
Upper respiratory tract infections are the most common diseases encountered in office pediatrics. The majority of these illnesses, including the common cold and pharyngitis, are viral in etiology, present with rhinitis and fever, and are self-limited and benign. Management consists of fluids, rest, saltwater nose drops and analgesics. Antihistamines appear to relieve only those symptoms potentiated by allergy. With the exception of streptococcal pharyngitis, upper respiratory tract infections do not require antibiotic therapy. However, otitis media and sinusitis, which sometimes are difficult to diagnose, are markedly improved by antibiotics that cover Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. In 10 percent of children, otitis media and sinusitis are recalcitrant to antibiotic therapy. For these patients, referral to an otolaryngologist, myringotomy, placement of tympanostomy tubes or a short trial of prednisone may be efficacious.
上呼吸道感染是门诊儿科中最常见的疾病。这些疾病中的大多数，包括普通感冒和咽炎，病因是病毒性的，表现为鼻炎和发热，具有自限性且为良性。治疗方法包括补充液体、休息、使用盐水滴鼻剂和止痛剂。抗组胺药似乎只能缓解那些由过敏引起的症状。除了链球菌性咽炎外，上呼吸道感染不需要抗生素治疗。然而，中耳炎和鼻窦炎有时难以诊断，使用覆盖肺炎链球菌、流感嗜血杆菌和卡他莫拉菌的抗生素可显著改善病情。在10%的儿童中，中耳炎和鼻窦炎对抗生素治疗无效。对于这些患者，转诊至耳鼻喉科医生、鼓膜切开术、放置鼓膜造孔管或短期试用泼尼松可能有效。
