For which condition is initial antibiotic therapy typically not recommended?

Initial antibiotic therapy is typically not recommended for acute bronchitis because this condition is most often caused by viral infections. Antibiotics are effective against bacteria, but they do not treat viral infections, which account for the majority of acute bronchitis cases. Instead, treatment generally focuses on symptom relief, such as using over-the-counter medications for cough and pain management.

In contrast, other conditions listed, such as streptococcal pharyngitis, acute bacterial sinusitis, and community-acquired pneumonia, are often caused by bacterial infections, which do require antibiotic treatment to effectively manage the infection and prevent complications. In these cases, clinical guidelines strongly support the use of antibiotics to eliminate the bacterial pathogens responsible for the illness.