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PATIENT INFORMATION
URTIs
Typical appearance of a
bacterium (magnified
90,000 times)
Typical appearance of
viruses (magnified
230,000 times)
What are upper respiratory tract
infections (URTIs)?
URTIs are infections of the upper respiratory tract which includes the nose, the sinuses, the throat and the middle ear. The most
common site for infection is the nose, and
this is called rhinitis.
What is the cause of URTIs?
They are caused by one of several viruses, usually the same ones that cause the
common cold, which is a type of URTI.
They are different from other germs called
bacteria, which can cause infections such as
tonsillitis or middle ear infection.
How common are URTIs in children?
They are very common. Infants tend to
develop them from the age of 4-6 months,
although they can occur earlier if children
are exposed to the viruses. The average
child can expect to get about six episodes
each year.
What are the symptoms?
The most common symptom is a runny,
snuffling nose. The discharge can vary in
nature from clear and watery to thick, green
mucus. Other symptoms include a sore
throat, ear pain and a cough. General symptoms may include fever, irritability, tiredness and a flushed face.
What is the usual outcome?
URTIs almost always get better naturally.
The body is good at fighting off these infections, and this may take several days.
Sometimes it may take a few weeks, especially with a snuffling nose.
What are the risks?
URTIs are usually not serious, and seem
and sound worse than they actually are.
Sometimes the viral infection is complicated by a bacterial infection, usually in the
middle ear. If so, the child can become quite
unwell. If you suspect this problem, the
child should be checked by your doctor.
You should contact your doctor if you
notice:
• Loss of activity (the child is quiet and
whimpers).
• Swelling and infection of the eye.
• Wheezing or other breathing difficulty.
• An unusually high fever.
• Neck stiffness — the child seems unwilling to move the neck.
• Pulling at an ear in obvious pain.
• Other unusual symptoms.
• The child’s condition seems to be generally deteriorating.
Why are antibiotics not usually prescribed?
They are not prescribed because they are
not necessary. Viruses are not destroyed by
the commonly prescribed antibiotics and
there is no evidence that giving them leads
to a quicker recovery compared with simple
supportive measures.
Another problem is antibiotic resistance.
Giving courses of antibiotics can result in
the bacteria in the body becoming resistant
to them and so the antibiotics are not effective later on when they are really needed for
a bacterial infection. The “superbugs” that
have emerged in the community and in hospital because of over-prescribing are a huge
problem for future generations.
We reserve antibiotics for complicated
cases such as middle ear infection.
What is the treatment?
Many supportive measures can be used to
relieve symptoms. Paracetamol mixture is
helpful for fever and pain. Throat lozenges
can help a sore throat and it is important to
keep drinking lots of fluid.
Cleaning the blocked nose in young
children
This is an easy task for parents. Make a
saline solution by mixing a teaspoon of salt
with 500mL of boiled water. Using a cotton
bud (dipped in warm saline), gently clear
out the secretions from the nose about every
two waking hours. Special saline nose drops
or spray (eg, Narium nasal mist) can be
instilled into the nose after it has been
cleaned. If this method is not effective and
there is a problem with feeding you can use a
paediatric decongestant nose drop or spray
preparation (such as Vasylox Junior or
Otrivin), but they should only be used for
4-5 days.
AUTHOR: PROFESSOR JOHN MURTAGH
Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes.