Feature Article

Acute respiratory tract infections in childhood

Merci MH Kusel, Peter D Sly



Most acute respiratory tract infections in developed countries are viral in aetiology and self-limiting. The use of antibiotics should only be considered if bacterial infection is suspected.

Key Points

  • Most acute respiratory infections (ARIs) in developed countries are viral in aetiology, uncomplicated and self-limiting.
  • Human metapneumovirus is a leading cause of ARIs in early childhood.
  • Respiratory viral infections are associated with most asthma exacerbations, particularly in children; rhinoviruses are the most commonly implicated virus.
  • The use of antibiotics in treating ARIs should only be considered in the presence of bacterial sequelae.
  • Although most children with ARIs can be managed in the community setting, some may be better referred to hospital.
  • Prevention strategies for ARIs include avoidance of environmental tobacco smoke exposure and immunisation against pneumococcal disease, invasive Haemophilus influenzae type b infection and, in some children, influenza.