The enormous consumption of antibiotics for these illnesses has contributed to the rise in antibiotic resistance among common community-acquired pathogens such as Streptococcus pneumoniae—a trend that in itself has had an enormous influence on public health. Although most URIs are caused by viruses, distinguishing patients with primary viral infection from those with primary bacterial infection is difficult. Signs and symptoms of bacterial and viral URIs are, in fact, indistinguishable. Because routine, rapid testing is neither available nor practical for most syndromes, acute infections are diagnosed largely on clinical grounds. .
