Challenges of managed care organizations in treating respiratory tract infections in an age of antibiotic resistance.

Managing respiratory tract infections (RTIs) presents many challenges to managed care organizations (MCOs). RTIs are among the most common illnesses treated by primary care clinicians; they seriously impact patient quality of life and are a leading cause of health-related absences from the workplace. The total direct costs of treating conditions such as acute otitis media, sinusitis, and acute exacerbations of chronic bronchitis are estimated to be $10.1 billion. The development of drug resistance has compounded these challenges by increasing treatment failures and costs and limiting treatment options. MCOs can meet these challenges by implementing clinical practice guidelines for acute respiratory infections, conducting focused studies of antibiotic use, and educating both healthcare clinicians and patients about appropriate antibiotic use.