BACKGROUND: There are few investigations into the aetiology of lower respiratory tract infections (LRTIs) in general practice. AIM: To describe the aetiology of LRTI among adult patients in general practice in The Netherlands. DESIGN OF STUDY: Prospective observational study. SETTING: General practices in the Leiden region, The Netherlands. METHOD: Adult patients with a defined LRTI were included. Standard medical history and physical examination were performed. Sputum, blood and throat swabs were collected for diagnostic tests. Aetiological diagnosis, categorised as definite or possible, was based on the results of bacterial and viral cultures, serological techniques, and on polymerase chain reaction. Proportions of pathogens causing LRTI were assessed in relation to chest X-ray findings. RESULTS: A bacterial cause was established in 43 (30%), and a viral cause in 57 (39%) of the 145 patients with a LRTI. Influenza virus A was the most frequently diagnosed microorganism, followed by Haemophilus influenzae, and Mycoplasma pneumoniae. Streptococcus pneumoniae was found in 6% of the patients. CONCLUSIONS: Pathogens were found in two-thirds of the patients. In half of these patients there was a viral cause. Influenza virus A was the most frequently found pathogen. The treatment with antibiotics of at least one-third of the patients with LRTI was superfluous. This observation should result in changes in the prescription of antibiotics in LRTI.
BACKGROUND: There are few investigations into the aetiology of lower respiratory tract infections (LRTIs) in general practice. AIM: To describe the aetiology of LRTI among adult patients in general practice in The Netherlands. DESIGN OF STUDY: Prospective observational study. SETTING: General practices in the Leiden region, The Netherlands. METHOD: Adult patients with a defined LRTI were included. Standard medical history and physical examination were performed. Sputum, blood and throat swabs were collected for diagnostic tests. Aetiological diagnosis, categorised as definite or possible, was based on the results of bacterial and viral cultures, serological techniques, and on polymerase chain reaction. Proportions of pathogens causing LRTI were assessed in relation to chest X-ray findings. RESULTS: A bacterial cause was established in 43 (30%), and a viral cause in 57 (39%) of the 145 patients with a LRTI. Influenza virus A was the most frequently diagnosed microorganism, followed by Haemophilus influenzae, and Mycoplasma pneumoniae. Streptococcus pneumoniae was found in 6% of the patients. CONCLUSIONS: Pathogens were found in two-thirds of the patients. In half of these patients there was a viral cause. Influenza virus A was the most frequently found pathogen. The treatment with antibiotics of at least one-third of the patients with LRTI was superfluous. This observation should result in changes in the prescription of antibiotics in LRTI.
Authors: A Willy Graffelman; Arie Knuistingh Neven; Saskia le Cessie; Aloys C M Kroes; Machiel P Springer; Peterhans J van den Broek Journal: Br J Gen Pract Date: 2004-01 Impact factor: 5.386
Authors: C Raherison; P Peray; R Poirier; P Romand; J P Grignet; P Arsac; A Taytard; J P Daures Journal: Eur Respir J Date: 2002-02 Impact factor: 16.671
Authors: A Willy Graffelman; Arie Knuistingh Neven; Saskia le Cessie; Aloys C M Kroes; Machiel P Springer; Peterhans J van den Broek Journal: Br J Gen Pract Date: 2004-01 Impact factor: 5.386
Authors: A Willy Graffelman; Francois E J A Willemssen; Harmine M Zonderland; Arie Knuistingh Neven; Aloys C M Kroes; Peterhans J van den Broek Journal: Br J Gen Pract Date: 2008-02 Impact factor: 5.386
Authors: Sunghoon Park; Kil Chan Oh; Ki-Seong Kim; Kyu-Tae Song; Kwang Ha Yoo; Yun Su Shim; Young Ju Lee; Myung Goo Lee; Jang Uk Yun; Hyun Su Kim; Yee Hyung Kim; Won Jun Lee; Do Il Kim; Hyung Gun Cha; Jae-Myung Lee; Jung San Seo; Ki-Suck Jung Journal: J Korean Med Sci Date: 2015-09-12 Impact factor: 2.153
Authors: Vivian M Raeven; Simone M C Spoorenberg; Wim G Boersma; Ewoudt M W van de Garde; Suzanne C Cannegieter; G P Paul Voorn; Willem Jan W Bos; Jim E van Steenbergen Journal: BMC Infect Dis Date: 2016-06-17 Impact factor: 3.090