A comprehensive overview of upper and lower respiratory infections in Türkiye

Abstract

Respiratory tract infections (RTIs) are among the leading causes of morbidity and healthcare utilization worldwide and pose a substantial public health burden in Türkiye. RTIs span a wide clinical spectrum, from self-limiting upper respiratory illnesses to severe, potentially life-threatening lower respiratory tract infections, affecting all age groups. This review summarizes the epidemiology, etiologic agents, diagnostic approaches, and antimicrobial resistance patterns of RTIs in Türkiye, with emphasis on viral and bacterial pathogens. National data show that viral agents, particularly influenza viruses, respiratory syncytial virus, rhinovirus, and seasonal coronaviruses, cause most acute RTIs, especially during winter months. Despite this predominance, empirical antibiotic prescribing remains common, contributing to high national antibiotic consumption and antimicrobial resistance. Declining penicillin susceptibility among Streptococcus pneumoniae illustrates persistent stewardship challenges, whereas Streptococcus pyogenes retains high susceptibility to first-line therapies, underscoring the value of accurate diagnosis. The review also outlines current diagnostic strategies, including culture-based methods, rapid antigen tests, and molecular assays, highlighting appropriate specimen collection and test selection to reduce diagnostic error. Key challenges include limited surveillance, underuse of rapid diagnostics, and inappropriate antibiotic use. Strengthening diagnostic capacity, expanding surveillance, and implementing targeted stewardship interventions are essential to improve RTI management and curb antimicrobial resistance in Türkiye.