Delayed prescription of antibiotics and the capabilities of herbal medicine when used in respiratory infections

Excessive and improper use of antibiotics in respiratory infections is still an urgent issue. In most cases of ARS and AT, antibiotics can be considered excessive treatment, since they are a completely inappropriate solution for viral infections. An important issue is negative changes to the microbiome in the patient’s body, which cause a negative impact on health, and abnormal changes can last longer and be more severe than the disease itself. Misuse of antibiotics can be harmful, especially in children, because the long-term effects of antibiotics on the macroorganism and microbiome can cause the disease to recur in adulthood. Sinupret® in the strategy of delayed prescription of antibiotics in ARS patients as part of a controlled study helps reduce prescription of antibacterials by 1.81 times and by 15.5 times (53% to 3.4%) versus statistics. Imupret® in patients with severe acute tonsillitis when employing the approach of delayed antibiotics prescription reduces the need for antibacterial therapy by 43.7% or 2.3 times, and by 11 times (72% to 10.1%) versus the average statistical level of prescription. Unlike antibiotics, herbal medicines positively affect the patient’s microbiome and have a favourable safety profile. It is imperative to increase knowledge and awareness, as well as provide appropriate training and communication strategies among physicians to prevent overuse and misuse of antibiotics. Herbal medicinal products BNO1016 (Sinupret®) and BNO1030 (Imupret®) can be considered as an alternative to antibiotics for the treatment of uncomplicated forms of acute rhinosinusitis and acute tonsillitis. Evidence shows that herbal medicines are effective and have a favourable safety profile. However, herbal medicinal products cannot replace antibiotics in all the cases, so delayed prescription of antibiotics with pre-treatment using herbal products can help reduce excessive and unjustified use of antibiotics.