Change in the use of diagnostic tests in the management of lower respiratory tract infections: a register-based study in primary care.
C-reactive protein
anti-bacterial agents
antibiotics
chest X-ray
community-acquired pneumonia
management
primary care
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
2020
2020
Historique:
received:
18
10
2019
accepted:
21
10
2019
pubmed:
5
3
2020
medline:
5
3
2020
entrez:
5
3
2020
Statut:
epublish
Résumé
Differentiating between pneumonia and acute bronchitis is often difficult in primary care. There is no consensus regarding clinical decision rules for pneumonia, and guidelines differ between countries. Use of diagnostic tests and change of management over time is not known. To calculate the proportion of diagnostic tests in the management of lower respiratory tract infections (LRTIs) in a low antibiotic prescribing country, and to evaluate if the use and prescription pattern has changed over time. A register-based study on data from electronic health records from January 2006 to December 2014 in the Kronoberg county of south east Sweden. Data regarding use of C-reactive protein (CRP), chest x-rays (CXRs), microbiological tests, and antibiotic prescriptions were assessed for patients aged 18-79 years, with the diagnosis pneumonia, acute bronchitis, or cough. A total of 54 229 sickness episodes were analysed. Use of CRP increased during the study period from 61.3% to 77.5% for patients with pneumonia ( Use of CRP and microbiological tests in the diagnostics of LRTIs increased despite the fact that the incidence of pneumonia and acute bronchitis was stable.
Sections du résumé
BACKGROUND
BACKGROUND
Differentiating between pneumonia and acute bronchitis is often difficult in primary care. There is no consensus regarding clinical decision rules for pneumonia, and guidelines differ between countries. Use of diagnostic tests and change of management over time is not known.
AIM
OBJECTIVE
To calculate the proportion of diagnostic tests in the management of lower respiratory tract infections (LRTIs) in a low antibiotic prescribing country, and to evaluate if the use and prescription pattern has changed over time.
DESIGN & SETTING
METHODS
A register-based study on data from electronic health records from January 2006 to December 2014 in the Kronoberg county of south east Sweden.
METHOD
METHODS
Data regarding use of C-reactive protein (CRP), chest x-rays (CXRs), microbiological tests, and antibiotic prescriptions were assessed for patients aged 18-79 years, with the diagnosis pneumonia, acute bronchitis, or cough.
RESULTS
RESULTS
A total of 54 229 sickness episodes were analysed. Use of CRP increased during the study period from 61.3% to 77.5% for patients with pneumonia (
CONCLUSION
CONCLUSIONS
Use of CRP and microbiological tests in the diagnostics of LRTIs increased despite the fact that the incidence of pneumonia and acute bronchitis was stable.
Identifiants
pubmed: 32127365
pii: bjgpopen20X101015
doi: 10.3399/bjgpopen20X101015
pmc: PMC7330198
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2020, The Authors.
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