Respiratory tract infections (RTIs) are infectious diseases involving the respiratory tract.

[1] An
infection of this type usually is further classified as an upper respiratory tract infection (URI or
URTI) or a lower respiratory tract infection (LRI or LRTI). Lower respiratory infections, such
as pneumonia, tend to be far more severe than upper respiratory infections, such as the common
cold.

Types[edit]
Upper respiratory tract infection[edit]
Main article: Upper respiratory tract infection
The upper respiratory tract is considered the airway above the glottis or vocal cords; sometimes,
it is taken as the tract above the cricoid cartilage. This part of the tract includes
the nose, sinuses, pharynx, and larynx.[2]
Typical infections of the upper respiratory tract
include tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, certain influenza types, and
the common cold.[3] Symptoms of URIs can include cough, sore throat, runny nose, nasal
congestion, headache, low-grade fever, facial pressure, and sneezing.[4][5]

Lower respiratory tract infection[edit]

Main article: Lower respiratory tract infection
The lower respiratory tract consists of the trachea (windpipe), bronchial tubes, bronchioles, and
the lungs.[citation needed]
Lower respiratory tract infections are generally more severe than upper respiratory infections.
LRIs are the leading cause of death among all infectious diseases.[6] The two most common LRIs
are bronchitis and pneumonia.[7] Influenza affects both the upper and lower respiratory tracts, but
more dangerous strains such as the highly pernicious H5N1 tend to bind to receptors deep in the
lungs.[8]
Respiratory System Anatomy

Diagnosis[edit]

Deaths from respiratory infections per million persons in 2012

24-120
121-151
152-200
201-244
245-346
347-445
446-675
676-866
867-1,209
1,210-2,090
Pulmonary Function Testing (PFT) allows for the evaluation and assessment of airways, lung
function, as well as specific benchmarks to diagnose an array of respiratory tract
infections.[9] Methods such as gas dilution techniques and plethysmography help determine the
functional residual capacity and total lung capacity.[9] To discover whether or not to perform a set
of advanced Pulmonary Function Testing will be based on abnormally high values in previous
test results.[9] A 2014 systematic review of clinical trials does not support routine rapid viral
testing to decrease antibiotic use for children in emergency departments.[10] It is unclear if rapid
viral testing in the emergency department for children with acute febrile respiratory infections
reduces the rates of antibiotic use, blood testing, or urine testing.[10] The relative risk reduction
of chest x-ray utilization in children screened with rapid viral testing is 77% compared with
controls.[10] In 2013 researchers developed a breath tester that can promptly diagnose lung
infections.[11][12]

Treatment[edit]
Bacteria are unicellular organisms present on Earth can thrive in various environments, including
the human body.[13] Antibiotics are a medicine designed to treat bacterial infections that need a
more severe treatment course; antibiotic use is not recommended for common bacterial
infections because the body is likely to treat them.[14] This medicine does not effectively treat a
viral infection like sore throats, influenza, bronchitis, sinusitis and common respiratory tract
infections.[15] This is due to antibiotic properties that only allow bacteria's termination; antibiotics
were not created to treat viruses.[16]
The CDC has reported that antibiotic prescription is high; 47 million prescriptions in the United
States in 2018 were made for infections that do not need antibiotics to be treated with.[17] It is
recommended to avoid antibiotic use unless bacterial infections are severe, transmissible, or
have a high risk of further complications if left untreated.[18] Unnecessary use of antibiotics could
increase antibiotic-resistant infections, affect the digestive system, create allergic reactions, and
other intense side effects.[19] A study published in JAMA found that narrow-spectrum antibiotics,
such as amoxicillin, are just as effective as broad-spectrum alternatives for treating acute
respiratory tract infections in children, but have a lower risk of side effects.[20]

Prevention[edit]
Despite the superior filtration capability of N95 filtering facepiece respirators measured in vitro,
insufficient clinical evidence has been published to determine whether standard surgical masks
and N95 filtering facepiece respirators are equivalent to preventing respiratory infections in
healthcare workers.[21]
Adults in intensive care units (ICU) have a higher risk of acquiring an RTI.[22] A combination of
topical and systematic antibiotics taken prophylactically can prevent infection and improve adults'
overall mortality in the ICU for adult patients receiving mechanical ventilation for at least 48
hours, and topical antibiotic prophylaxis probably reduces respiratory infections but not
mortality.[22] However, the combination of treatments cannot rule out the relevant contribution in
the systemic component of the observed reduction of mortality.[22] There is no sufficient evidence
to recommend that antibiotics be used to prevent complications from an RTI of unknown cause in
children under the age of 5 years old.[23] High-quality clinical research in the form of randomized
controlled trials assessed the effectiveness of Vitamin D,[24] another review of poorer quality
RCTs addressed the effectiveness of immunostimulants for preventing respiratory tract
infections.[25] Despite some uncertainty due to small study sizes, there is some evidence that
exercise may reduce severity of symptoms but had no impact on number of episodes or number
of symptom days per episode.[26]
Viruses that cause RTI are more transmissible at very high or low relative humidity; ideal
humidity for indoor spaces is between 40 and 60%. Therefore, relative humidity in this range can
help lessen the risk of aerosol transmission.[27]

Epidemiology[edit]
Respiratory infections often have strong seasonal patterns, with temperate climates more
affected during the winter. Several factors explain winter peaks in respiratory infections, including
environmental conditions and changes in human behaviors. Viruses that cause respiratory
infections are affected by environmental conditions like relative humidity and temperature.
Temperate climate winters have lower relative humidity, which is known to increase the
transmission of influenza.[27]
Of the viruses that cause respiratory infections in humans, most have seasonal variation in
prevalence. Influenza, Human orthopneumovirus (RSV), and human coronaviruses are more
prevalent in the winter. Human bocavirus and Human metapneumovirus occur year-
round, rhinoviruses (which cause the common cold) occur mostly in the spring and fall,
and human parainfluenza viruses have variable peaks depending on the specific
strain. Enteroviruses, with the exception of rhinoviruses, tend to peak in the summer.[27]