Treatment of acute cough/lower respiratory tract infection by antibiotic class and associated outcomes: a 13 European country observational study in primary care

2010 ◽  
Vol 65 (11) ◽  
pp. 2472-2478 ◽  
Author(s):  
C. C. Butler ◽  
K. Hood ◽  
M. J. Kelly ◽  
H. Goossens ◽  
T. Verheij ◽  
...  
Keyword(s):  
Primary Care ◽  
Tract Infection ◽  
Observational Study ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
European Country ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Acute Cough

scholarly journals Clinical relevance of bacterial resistance in lower respiratory tract infection in primary care: secondary analysis of a multicentre European trial

2018 ◽  
Vol 68 (674) ◽  
pp. e627-e632
Author(s):  
Jolien Teepe ◽  
Berna DL Broekhuizen ◽  
Herman Goossens ◽  
Patricia Marinka Hordijk ◽  
Katherine Loens ◽  
...  
Keyword(s):  
Primary Care ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Secondary Analysis ◽  
Acute Cough ◽  
Antibiotic Resistant ◽  
Duration Of Symptoms

BackgroundThe impact of antimicrobial resistance on clinical outcomes in patients with lower respiratory tract infection in primary care is largely unknown.AimTo determine the illness course of infections with resistant bacteria in adults presenting to primary care with acute cough.Design and settingSecondary analysis of a multicentre European trial in primary care.MethodA total of 2061 adults with acute cough (lasting ≤28 days) were recruited from primary care and randomised to amoxicillin or placebo. To reflect the natural course of disease, only patients in the placebo group (n = 1021) were eligible. Nasopharyngeal flocked swabs and/or sputa (when available) were analysed at baseline and Streptococcus pneumoniae and Haemophilus influenzae isolates underwent susceptibility testing. Patients recorded their symptoms in a diary every day for 4 weeks. Patients with and without resistant bacterial infection were compared with regards to symptom severity, duration of symptoms, worsening of illness, and duration of interference with normal activities or work.ResultsOf the 834 patients with diary records, 104 showed S. pneumoniae and/or H. influenzae infection. Of this number, 54 (52%) were resistant to antibiotics, while seven (7%) were resistant to penicillin. For the duration of symptoms rated ‘moderately bad or worse’ (hazard ratio 1.27, 95% confidence interval [CI] = 0.67 to 2.44), mean symptom severity (difference −0.48, 95% CI = −1.17 to 0.21), and worsening of illness (odds ratio 0.31, 95% CI = 0.07 to 1.41), there was no statistically significant difference between the antibiotic-resistant and antibiotic-sensitive groups.ConclusionThe illness course of antibiotic-resistant lower respiratory tract infection does not differ from that caused by antibiotic-sensitive bacteria.

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