Tailoring Antibiotic Duration for Respiratory Tract Infections in Primary Care

Inclusion Criteria: * Either adults with a) acute cough (new cough or worsening of a previous cough) as the predominant symptom which the clinician believes to be a bacterial acute lower RTI, such as community-acquired pneumonia, acute bronchitis or acute chronic obstructive pulmonary disease (COPD) exacerbations, or b) an acute bacterial rhinosinusitis * Doctors deem beta-lactam therapy (given every eight hours for a minimum of seven days) is necessary Exclusion Criteria: * RTIs different from a lower RTI or acute rhinosinusitis * Patients with suspected septicemia (quick Quick Sequential Organ Failure Assessment: respiratory rate ≥22 breaths/minute, systolic blood pressure \<100 mm Hg or altered mental status with a Glasgow score \< 5) ≥2 * Patients with pneumonia and \[Confusion, respiratory rate ≥30 breaths/minute, blood pressure \< 90/60 mm Hg, or age \>65 yr.\] ≥1 * Patients with very severe COPD (Forced Expiratory Volume in One Second \<30%) * Patients with COPD who have taken four or more antibiotic courses in the previous year, presence of significant bronchiectasis, and/or isolation of Pseudomonas in a previous sputum culture * Patients with reported allergy to beta-lactams * Patients who have taken an antibiotic in the previous two weeks * Patients who have been hospitalized in the last two weeks * A working diagnosis of a non-infective disorder, such as heart failure, pulmonary embolus, esophageal reflux * Immunocompromised patients, such as HIV infection, pati…