Acute respiratory infection
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"Respiratory Tract Infections"[MeSH Terms]
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WHO acute respiratory infections fact sheet symptoms emergency warning signs
Acute respiratory infection (ARI) is a sudden infection of the airways, from the nose and throat to the lungs. It includes the common cold, influenza, COVID-19, acute bronchitis, bronchiolitis, and pneumonia.
Common symptoms
- Runny or blocked nose, sore throat
- Cough, fever, fatigue, body aches
- Fast breathing, wheeze, chest discomfort
- In more serious cases: shortness of breath or low oxygen
Most ARIs are viral and improve with rest, fluids, and symptom relief. Antibiotics do not help viral infections and should be used only when a clinician suspects or confirms a bacterial illness, such as some pneumonias.
Seek urgent medical care now for difficulty breathing, blue/gray lips or face, chest pain, confusion, inability to stay awake, signs of dehydration, coughing blood, or rapidly worsening symptoms. Infants, older adults, pregnant people, and people with chronic lung/heart disease or weakened immunity should be assessed sooner. WHO describes influenza as a common acute respiratory infection and notes typical symptoms of abrupt fever, cough, sore throat, aches, and fatigue in its influenza fact sheet.
If you mean a current illness, tell me the person’s age, symptoms, duration, temperature, breathing difficulty, and relevant conditions, and I can help assess the appropriate next step.
Find the latest guidelines for acute respiratory infections
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site:who.int acute respiratory infection guideline pneumonia 2025 2026 children adults
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site:cdc.gov outpatient acute respiratory infection adult treatment guideline 2025
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site:nice.org.uk respiratory tract infections antimicrobial prescribing guideline pneumonia 2025 2026
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https://www.cdc.gov/antibiotic-use/hcp/clinical-care/adult-o…
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"Respiratory Tract Infections"[MeSH Terms] AND "Practice Guideline"[Publication Type]
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"Pneumonia"[MeSH Terms] AND "Practice Guideline"[Publication Type]
“Acute respiratory infection” is an umbrella term, so there is no single guideline covering every age group and cause. The most relevant current guidance is:
| Setting / condition | Latest key guideline or guidance | Main use |
|---|---|---|
| Adults aged 16+ with suspected ARI | NICE guideline summary, 2024 | First clinical assessment, identifying severe illness, deciding on community versus hospital care, and considering pneumonia, influenza, COVID-19, sepsis, pulmonary embolism, and exacerbations of chronic lung disease. |
| Adult community-acquired pneumonia | ATS clinical practice guideline, 2026 | Diagnosis and management of adult community-acquired pneumonia, including antibiotic strategy and selected adjunctive therapies. This is the newest major adult CAP guideline identified. |
| Adult outpatient URI, bronchitis, sinusitis | CDC outpatient antibiotic guidance | Antibiotic stewardship. Do not routinely prescribe antibiotics for uncomplicated acute bronchitis. Assess for pneumonia when abnormal vital signs or focal chest findings are present. For uncomplicated bacterial sinusitis, use watchful waiting when appropriate; amoxicillin or amoxicillin-clavulanate are first-line options. |
| Suspected influenza or COVID-19 in higher-risk outpatients | CDC combined outpatient guidance | Start indicated antivirals early. For influenza, treat suspected or confirmed progressive disease or high-risk patients promptly. For COVID-19, eligible high-risk patients should receive treatment as soon as possible, within the relevant treatment window; do not delay solely for a test result. |
| Children with pneumonia | WHO pneumonia guidance page | WHO notes that pneumonia can be viral or bacterial; bacterial pneumonia requires antibiotics, with oral amoxicillin commonly used for non-severe cases, while severe pneumonia needs hospital-level assessment and treatment. |
| Acute cough / acute bronchitis | NICE acute-cough guidance | Acute cough is usually viral, and often lasts around 18 days, sometimes 3 to 4 weeks. Antibiotics are generally not indicated unless there is a specific bacterial diagnosis or complication. |
Practical points consistent across current guidance
- First assess severity, especially breathing rate/work of breathing, oxygen saturation, mental status, hydration, blood pressure, fever, and risk factors.
- Do not assume discolored sputum means bacterial infection. It alone does not justify antibiotics.
- Consider testing for influenza, SARS-CoV-2, and RSV when the result will change treatment, infection-control measures, or disposition.
- Use antibiotics for suspected/confirmed bacterial pneumonia, bacterial sinusitis meeting clinical criteria, pertussis, or other defined bacterial disease, guided by local resistance and prescribing recommendations.
- Provide symptomatic care and safety-net instructions for uncomplicated viral illness.
- Prevent infection with recommended influenza, COVID-19, pneumococcal, RSV, and pertussis vaccines, according to age, pregnancy status, comorbidities, and national program.
Urgent referral / emergency assessment
Urgent evaluation is indicated for respiratory distress, cyanosis, low oxygen saturation, chest pain, confusion, hypotension, inability to maintain hydration, hemoptysis, or rapid deterioration. Infants, older adults, pregnant people, immunocompromised patients, and people with cardiopulmonary disease need a lower threshold for assessment.
The recommendations above should be adapted to the country’s formulary, local resistance data, age group, pregnancy, renal function, and comorbidities.
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