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Teepe, Jolien; Broekhuizen, Berna DL; Goossens, Herman; Hordijk, Patricia Marinka; Loens, Katherine; Lammens, Christine; Ieven, Margareta; Little, Paul; Butler, Chris C; Coenen, Samuel; Godycki-Cwirko, Maciek; Henriques-Normark, Birgitta; Verheij, Theo JM

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

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  • Medientyp: E-Artikel
  • Titel: Clinical relevance of bacterial resistance in lower respiratory tract infection in primary care: secondary analysis of a multicentre European trial
  • Beteiligte: Teepe, Jolien; Broekhuizen, Berna DL; Goossens, Herman; Hordijk, Patricia Marinka; Loens, Katherine; Lammens, Christine; Ieven, Margareta; Little, Paul; Butler, Chris C; Coenen, Samuel; Godycki-Cwirko, Maciek; Henriques-Normark, Birgitta; Verheij, Theo JM
  • Erschienen: Royal College of General Practitioners, 2018
  • Erschienen in: British Journal of General Practice
  • Sprache: Englisch
  • DOI: 10.3399/bjgp18x698333
  • ISSN: 0960-1643; 1478-5242
  • Schlagwörter: Family Practice
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Background</jats:title><jats:p>The impact of antimicrobial resistance on clinical outcomes in patients with lower respiratory tract infection in primary care is largely unknown.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To determine the illness course of infections with resistant bacteria in adults presenting to primary care with acute cough.</jats:p></jats:sec><jats:sec><jats:title>Design and setting</jats:title><jats:p>Secondary analysis of a multicentre European trial in primary care.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A 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 (<jats:italic>n</jats:italic> = 1021) were eligible. Nasopharyngeal flocked swabs and/or sputa (when available) were analysed at baseline and <jats:italic>Streptococcus pneumoniae</jats:italic> and <jats:italic>Haemophilus influenzae</jats:italic> 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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 834 patients with diary records, 104 showed <jats:italic>S. pneumoniae</jats:italic> and/or <jats:italic>H. influenzae</jats:italic> 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.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The illness course of antibiotic-resistant lower respiratory tract infection does not differ from that caused by antibiotic-sensitive bacteria.</jats:p></jats:sec>
  • Zugangsstatus: Freier Zugang