@occasionalrain wrote:
All those urgent care places over prescribe. Most leave with a script for antibiotics; the reason we now have resistant bacteria. How can one have an upper respiratory infection without lung congestion?
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@occasionalrain, as a nurse of many years, I will be glad to answer your question. It is really more common to have an upper respiratory infection without any involvement of the lungs or have any lung congestion.
An upper respiratory infection is defined as an infection which involves either the nasal passages, the pharynx, or the larynx. It can be caused by a multitude of different microbes. Generally, the most common cause of an upper respiratory infection is some type of rhinovirus. There are more than a hundred different strains of rhinoviruses that are causative agents of upper respiration infections (URI). But, it is most common for the URI to only involve airway passages of the upper airways as stated above with no congestion or involvement of any type in the lungs.
Anything involving the bronchi or the lungs is generally termed lower respiratory infection.
So they are 2 totally different things. There are a few cases that due to decreased immune status combined with a real nasty microbe that a URI may progress to a LRI. This can certainly happen with particular strains of influenza viruses. But in most cases, there are literally tens of thousands of URIs that occur every day globally that don't ever progress to any type of lower respiratory infection or involve any type of lung congestion.
And as another side note, after reading the thread & hearing about @gidgetgh's situation, I would say the doc practiced treatment that exhibits "upstream thinking". She has some type of a URI that is persistent, also has a history of EBV, along with a thyroid condition. That combined with the stress of being a caregiver for her husband places her at a documented increased risk of developing a secondary bacterial infection. So she would certainly fall within a category for docs to consider dispensing antibiotics. You are correct, that over prescribing antibiotics is the number one reason of multi-drug resistant bacteria.
However, in this case it demonstrates someone that doesn't fall into the "typical" box due to her medical history and caregiver role. There is also the risk of her cortisol levels going sky high due to being sick on top of her caregiving responsibilities. Elevated cortisol levels really play havoc with one's immune system & place individuals are increased risk of advanced disease/illness.
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