[Infection causing pathogens in the area of the upper respiratory tract. Bacteriologic diagnosis and chemotherapy from the viewpoint of the bacteriologist].
After a short survey of the indigenous bacterial flora, and of the important bacteria causing infections of the upper respiratory tract, the conditions which are mandatory for proper evaluation of the bacteriological results and which must be observed by the physician in obtaining and forwarding specimens are discussed. Swabs must be sent in preservation media; otherwise the detection rate of viable organisms will fall considerably. Transport should therefore be as rapid as possible. Viral infections often pave the way of infections of the upper respiratory tract. In hospitalised patients however the suppression of the normal flora and selection of resistant strains by antibiotics often play the major role. Chemotherapy should be preceded by bacteriological investigation or, at least, by taking a suitable specimen for the detection of the causal bacteria and determination of their susceptibility to antibiotics. "Blind" therapy will result in 20-30% failures of the treatment. The following questions should be answered before antibiotics are started: Is there really a need for immediate chemotherapy? How likely are the causal bacteria to be sensitive? What defence mechanisms can be expected from the patient? What side effects of the antibiotic must be taken into consideration? The most important infections of the upper respiratory tract, the selection of effective antibiotics and the susceptibility of the more frequent pathogens of this area are also discussed. Finally some aspects of perioperative prophylaxis of infections after surgery of the upper respiratory tract are described.