Catherine M Smith1, Laura J Shallcross2, Peter Dutey-Magni2, Anne Conolly3, Christopher Fuller2, Suzanne Hill3, Arnoupe Jhass2,4, Franziska Marcheselli3, Susan Michie5, Jennifer S Mindell6, Matthew J Ridd7, Georgios Tsakos6, Andrew C Hayward8, Ellen B Fragaszy2,9. 1. Institute of Health informatics, UCL, 222 Euston Road, London, NW1 2DA, UK. catherine.m.smith@ucl.ac.uk. 2. Institute of Health informatics, UCL, 222 Euston Road, London, NW1 2DA, UK. 3. NatCen Social Research, 35 Northampton Square, London, EC1V 0AX, UK. 4. Research Department of Primary Care and Population Health, UCL, Rowland Hill Street, London, NW3 2PF, UK. 5. Centre for Behaviour Change, UCL, 1-19 Torrington Place, London, WC1E 7HB, UK. 6. Research Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London, WC1E 7HB, UK. 7. Health Science Institute, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK. 8. Institute of Epidemiology and Health Care, UCL, 1-19 Torrington Place, London, WC1E 7HB, UK. 9. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Abstract
BACKGROUND: Better information on the typical course and management of acute common infections in the community could inform antibiotic stewardship campaigns. We aimed to investigate the incidence, management, and natural history of a range of infection syndromes (respiratory, gastrointestinal, mouth/dental, skin/soft tissue, urinary tract, and eye). METHODS: Bug Watch was an online prospective community cohort study of the general population in England (2018-2019) with weekly symptom reporting for 6 months. We combined symptom reports into infection syndromes, calculated incidence rates, described the proportion leading to healthcare-seeking behaviours and antibiotic use, and estimated duration and severity. RESULTS: The cohort comprised 873 individuals with 23,111 person-weeks follow-up. The mean age was 54 years and 528 (60%) were female. We identified 1422 infection syndromes, comprising 40,590 symptom reports. The incidence of respiratory tract infection syndromes was two per person year; for all other categories it was less than one. 194/1422 (14%) syndromes led to GP (or dentist) consultation and 136/1422 (10%) to antibiotic use. Symptoms usually resolved within a week and the third day was the most severe. CONCLUSIONS: Most people reported managing their symptoms without medical consultation. Interventions encouraging safe self-management across a range of acute infection syndromes could decrease pressure on primary healthcare services and support targets for reducing antibiotic prescribing.
BACKGROUND: Better information on the typical course and management of acute common infections in the community could inform antibiotic stewardship campaigns. We aimed to investigate the incidence, management, and natural history of a range of infection syndromes (respiratory, gastrointestinal, mouth/dental, skin/soft tissue, urinary tract, and eye). METHODS: Bug Watch was an online prospective community cohort study of the general population in England (2018-2019) with weekly symptom reporting for 6 months. We combined symptom reports into infection syndromes, calculated incidence rates, described the proportion leading to healthcare-seeking behaviours and antibiotic use, and estimated duration and severity. RESULTS: The cohort comprised 873 individuals with 23,111 person-weeks follow-up. The mean age was 54 years and 528 (60%) were female. We identified 1422 infection syndromes, comprising 40,590 symptom reports. The incidence of respiratory tract infection syndromes was two per person year; for all other categories it was less than one. 194/1422 (14%) syndromes led to GP (or dentist) consultation and 136/1422 (10%) to antibiotic use. Symptoms usually resolved within a week and the third day was the most severe. CONCLUSIONS: Most people reported managing their symptoms without medical consultation. Interventions encouraging safe self-management across a range of acute infection syndromes could decrease pressure on primary healthcare services and support targets for reducing antibiotic prescribing.
Entities:
Keywords:
Antibiotic stewardship; Incidence; common infections; community cohort studies; healthcare-seeking behaviour
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