Literature DB >> 30061194

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

Jolien Teepe1, Berna Dl Broekhuizen1, Herman Goossens2, Patricia Marinka Hordijk1, Katherine Loens2, Christine Lammens2, Margareta Ieven2, Paul Little3, Chris C Butler4, Samuel Coenen5, Maciek Godycki-Cwirko6, Birgitta Henriques-Normark7, Theo Jm Verheij1.   

Abstract

BACKGROUND: The impact of antimicrobial resistance on clinical outcomes in patients with lower respiratory tract infection in primary care is largely unknown. AIM: To determine the illness course of infections with resistant bacteria in adults presenting to primary care with acute cough. DESIGN AND
SETTING: Secondary analysis of a multicentre European trial in primary care.
METHOD: 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 (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.
RESULTS: Of 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.
CONCLUSION: The illness course of antibiotic-resistant lower respiratory tract infection does not differ from that caused by antibiotic-sensitive bacteria. © British Journal of General Practice 2018.

Entities:  

Keywords:  antimicrobial drug resistance; cough; lower respiratory tract infection; primary care; prognosis

Mesh：

Substances：

Year:  2018        PMID： 30061194      PMCID： PMC6104862          DOI： 10.3399/bjgp18X698333

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN： 0960-1643            Impact factor:   5.386


  19 in total

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6.  Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997.

Authors:  D R Feikin; A Schuchat; M Kolczak; N L Barrett; L H Harrison; L Lefkowitz; A McGeer; M M Farley; D J Vugia; C Lexau; K R Stefonek; J E Patterson; J H Jorgensen
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7.  Antibiotic-resistant infections in primary care are symptomatic for longer and increase workload: outcomes for patients with E. coli UTIs.

Authors:  Christopher C Butler; Sharon Hillier; Zoë Roberts; Frank Dunstan; Anthony Howard; Stephen Palmer
Journal:  Br J Gen Pract       Date:  2006-09       Impact factor: 5.386

8.  Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.

Authors:  Herman Goossens; Matus Ferech; Robert Vander Stichele; Monique Elseviers
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9.  Pneumonia caused by penicillin-non-susceptible and penicillin-susceptible pneumococci in adults: a case-control study.

Authors:  S Einarsson; M Kristjansson; K G Kristinsson; G Kjartansson; S Jonsson
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10.  Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial.

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